| National Provider Identifier [NPI]: | 1700950052 |
| Last Name Of The Provider | PELC |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7794 5 MILE RD |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452302368 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2966 |
| Number Of Medicare Beneficiaries | 788 |
| Total Submitted Charge Amount | 297221 |
| Total Medicare Allowed Amount | 185448.65 |
| Total Medicare Payment Amount | 132014.31 |
| Total Medicare Standardized Payment Amount | 133471.09 |
| Drug Suppress Indicator | * |
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| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 369 |
| Number Of Beneficiaries Age 75 to 84 | 279 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 425 |
| Number Of Male Beneficiaries | 363 |
| Number Of Non Hispanic White Beneficiaries | 771 |
| 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 | 761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9785 |