| National Provider Identifier [NPI]: | 1134125412 |
| Last Name Of The Provider | TEPPER |
| First Name Of The Provider | NELLY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1743 GOUCHER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOHNSTOWN |
| Zip Code Of The Provider | 159051205 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 785 |
| Number Of Medicare Beneficiaries | 435 |
| Total Submitted Charge Amount | 121589 |
| Total Medicare Allowed Amount | 54341.63 |
| Total Medicare Payment Amount | 36516.71 |
| Total Medicare Standardized Payment Amount | 38691.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1450 |
| Total Drug Medicare AllowedAmount | 307.74 |
| Total Drug Medicare PaymentAmount | 251.07 |
| Total Drug Medicare Standardized Payment Amount | 251.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 743 |
| Number Of Medicare Beneficiaries With Medical Services | 435 |
| Total Medical Submitted Charge Amount | 120139 |
| Total Medical Medicare Allowed Amount | 54033.89 |
| Total Medical Medicare Payment Amount | 36265.64 |
| Total Medical Medicare Standardized Payment Amount | 38440.58 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 170 |
| Number Of Non Hispanic White Beneficiaries | 410 |
| Number Of Black or African American Beneficiaries | |
| 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 | 403 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.956 |