| National Provider Identifier [NPI]: | 1700899614 |
| Last Name Of The Provider | MANTELL |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 PINELLAS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563804 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 474 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 1122386.09 |
| Total Medicare Allowed Amount | 77232.21 |
| Total Medicare Payment Amount | 60212.43 |
| Total Medicare Standardized Payment Amount | 58880.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 474 |
| Number Of Medicare Beneficiaries With Medical Services | 324 |
| Total Medical Submitted Charge Amount | 1122386.09 |
| Total Medical Medicare Allowed Amount | 77232.21 |
| Total Medical Medicare Payment Amount | 60212.43 |
| Total Medical Medicare Standardized Payment Amount | 58880.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 167 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 297 |
| 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 | 277 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7624 |