| National Provider Identifier [NPI]: | 1447411970 |
| Last Name Of The Provider | MERCADO |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3580 PEACH ST |
| Street Address 2 Of The Provider | SUITE 103A |
| City Of The Provider | ERIE |
| Zip Code Of The Provider | 165082776 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 2527 |
| Number Of Medicare Beneficiaries | 851 |
| Total Submitted Charge Amount | 406967 |
| Total Medicare Allowed Amount | 233016.69 |
| Total Medicare Payment Amount | 180049.24 |
| Total Medicare Standardized Payment Amount | 166523.18 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 175 |
| Number Of Beneficiaries Age 65 to 74 | 307 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 132 |
| Number Of Female Beneficiaries | 445 |
| Number Of Male Beneficiaries | 406 |
| Number Of Non Hispanic White Beneficiaries | 798 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
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| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 568 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 283 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 55 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.288 |