| National Provider Identifier [NPI]: | 1548231236 |
| Last Name Of The Provider | ZELLNER |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13813 METRO PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339124343 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 6283 |
| Number Of Medicare Beneficiaries | 774 |
| Total Submitted Charge Amount | 712245.5 |
| Total Medicare Allowed Amount | 340712.25 |
| Total Medicare Payment Amount | 249954.16 |
| Total Medicare Standardized Payment Amount | 241472.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 2946 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 18930.5 |
| Total Drug Medicare AllowedAmount | 8178.33 |
| Total Drug Medicare PaymentAmount | 6596.26 |
| Total Drug Medicare Standardized Payment Amount | 6596.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 3337 |
| Number Of Medicare Beneficiaries With Medical Services | 774 |
| Total Medical Submitted Charge Amount | 693315 |
| Total Medical Medicare Allowed Amount | 332533.92 |
| Total Medical Medicare Payment Amount | 243357.9 |
| Total Medical Medicare Standardized Payment Amount | 234875.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 399 |
| Number Of Male Beneficiaries | 375 |
| Number Of Non Hispanic White Beneficiaries | 737 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 733 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0793 |