| National Provider Identifier [NPI]: | 1902955271 |
| Last Name Of The Provider | RACHUBA |
| First Name Of The Provider | MANDY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3333 N CALVERT ST |
| Street Address 2 Of The Provider | JPB SUITE LL08 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212182867 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 721 |
| Number Of Medicare Beneficiaries | 197 |
| Total Submitted Charge Amount | 271929.6 |
| Total Medicare Allowed Amount | 84519.51 |
| Total Medicare Payment Amount | 65228.49 |
| Total Medicare Standardized Payment Amount | 68914.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 118 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 61711.02 |
| Total Drug Medicare AllowedAmount | 28917.79 |
| Total Drug Medicare PaymentAmount | 22671.16 |
| Total Drug Medicare Standardized Payment Amount | 22671.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 603 |
| Number Of Medicare Beneficiaries With Medical Services | 197 |
| Total Medical Submitted Charge Amount | 210218.58 |
| Total Medical Medicare Allowed Amount | 55601.72 |
| Total Medical Medicare Payment Amount | 42557.33 |
| Total Medical Medicare Standardized Payment Amount | 46243.65 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 173 |
| 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 | 182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0486 |