| National Provider Identifier [NPI]: | 1558433904 |
| Last Name Of The Provider | FELLOWS |
| First Name Of The Provider | NEAL |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 HALL ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | TRAVERSE CITY |
| Zip Code Of The Provider | 496842288 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 3129 |
| Number Of Medicare Beneficiaries | 281 |
| Total Submitted Charge Amount | 198316.52 |
| Total Medicare Allowed Amount | 78956.51 |
| Total Medicare Payment Amount | 56271.77 |
| Total Medicare Standardized Payment Amount | 58337.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1887 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 25037.52 |
| Total Drug Medicare AllowedAmount | 17734.25 |
| Total Drug Medicare PaymentAmount | 13444.83 |
| Total Drug Medicare Standardized Payment Amount | 13444.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 1242 |
| Number Of Medicare Beneficiaries With Medical Services | 280 |
| Total Medical Submitted Charge Amount | 173279 |
| Total Medical Medicare Allowed Amount | 61222.26 |
| Total Medical Medicare Payment Amount | 42826.94 |
| Total Medical Medicare Standardized Payment Amount | 44892.54 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | 230 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| 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 | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 57 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3182 |