| National Provider Identifier [NPI]: | 1699023085 |
| Last Name Of The Provider | MENDELSON |
| First Name Of The Provider | VICKI |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30701 BARRINGTON ST |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | MADISON HEIGHTS |
| Zip Code Of The Provider | 480715135 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 1607 |
| Number Of Medicare Beneficiaries | 850 |
| Total Submitted Charge Amount | 199775 |
| Total Medicare Allowed Amount | 124677.93 |
| Total Medicare Payment Amount | 96891.92 |
| Total Medicare Standardized Payment Amount | 105260.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 1607 |
| Number Of Medicare Beneficiaries With Medical Services | 850 |
| Total Medical Submitted Charge Amount | 199775 |
| Total Medical Medicare Allowed Amount | 124677.93 |
| Total Medical Medicare Payment Amount | 96891.92 |
| Total Medical Medicare Standardized Payment Amount | 105260.83 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 480 |
| Number Of Male Beneficiaries | 370 |
| Number Of Non Hispanic White Beneficiaries | 678 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 740 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 28 |
| Average HCC Risk Score Of Beneficiaries | 2.3607 |