| National Provider Identifier [NPI]: | 1326368689 |
| Last Name Of The Provider | MANOHAR |
| First Name Of The Provider | JAISHREE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1945 VERSAILLES ST |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342396900 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 16897.6 |
| Number Of Medicare Beneficiaries | 480 |
| Total Submitted Charge Amount | 1073557.83 |
| Total Medicare Allowed Amount | 503998.91 |
| Total Medicare Payment Amount | 387402.98 |
| Total Medicare Standardized Payment Amount | 389654.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 13385.6 |
| Number Of Medicare Beneficiaries With Drug Services | 325 |
| Total Drug Submitted ChargeAmount | 528947.51 |
| Total Drug Medicare AllowedAmount | 190157.7 |
| Total Drug Medicare PaymentAmount | 149012.24 |
| Total Drug Medicare Standardized Payment Amount | 149012.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 3512 |
| Number Of Medicare Beneficiaries With Medical Services | 480 |
| Total Medical Submitted Charge Amount | 544610.32 |
| Total Medical Medicare Allowed Amount | 313841.21 |
| Total Medical Medicare Payment Amount | 238390.74 |
| Total Medical Medicare Standardized Payment Amount | 240642.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 209 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 356 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 443 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 449 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 28 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2318 |