| National Provider Identifier [NPI]: | 1982876868 |
| Last Name Of The Provider | BENNETT |
| First Name Of The Provider | ZELDA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7676 NEW HAMPSHIRE AVE |
| Street Address 2 Of The Provider | SUITE 420 |
| City Of The Provider | TAKOMA PARK |
| Zip Code Of The Provider | 209127512 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 261 |
| Number Of Medicare Beneficiaries | 131 |
| Total Submitted Charge Amount | 26561.8 |
| Total Medicare Allowed Amount | 17177.4 |
| Total Medicare Payment Amount | 10834.98 |
| Total Medicare Standardized Payment Amount | 12035.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 60.45 |
| Total Drug Medicare AllowedAmount | 28.52 |
| Total Drug Medicare PaymentAmount | 22.05 |
| Total Drug Medicare Standardized Payment Amount | 22.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 235 |
| Number Of Medicare Beneficiaries With Medical Services | 131 |
| Total Medical Submitted Charge Amount | 26501.35 |
| Total Medical Medicare Allowed Amount | 17148.88 |
| Total Medical Medicare Payment Amount | 10812.93 |
| Total Medical Medicare Standardized Payment Amount | 12013 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.882 |