| National Provider Identifier [NPI]: | 1316908866 |
| Last Name Of The Provider | DELPORT |
| First Name Of The Provider | ELVA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MKD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4735 OGLETOWN-STANTON RD |
| Street Address 2 Of The Provider | SUITE 2210 |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 19713 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 2566 |
| Number Of Medicare Beneficiaries | 482 |
| Total Submitted Charge Amount | 1325311.34 |
| Total Medicare Allowed Amount | 235640.31 |
| Total Medicare Payment Amount | 175889.44 |
| Total Medicare Standardized Payment Amount | 164144.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 472 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 4890.34 |
| Total Drug Medicare AllowedAmount | 411.2 |
| Total Drug Medicare PaymentAmount | 315.16 |
| Total Drug Medicare Standardized Payment Amount | 315.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2094 |
| Number Of Medicare Beneficiaries With Medical Services | 482 |
| Total Medical Submitted Charge Amount | 1320421 |
| Total Medical Medicare Allowed Amount | 235229.11 |
| Total Medical Medicare Payment Amount | 175574.28 |
| Total Medical Medicare Standardized Payment Amount | 163828.99 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 311 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 425 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 447 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1538 |