| National Provider Identifier [NPI]: | 1619925971 |
| Last Name Of The Provider | MINK |
| First Name Of The Provider | JERROLD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8670 WILSHIRE BLVD STE 101 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEVERLY HILLS |
| Zip Code Of The Provider | 902112930 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 9669 |
| Number Of Medicare Beneficiaries | 4232 |
| Total Submitted Charge Amount | 4717162.85 |
| Total Medicare Allowed Amount | 810548.6 |
| Total Medicare Payment Amount | 617503.55 |
| Total Medicare Standardized Payment Amount | 550434.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1746 |
| Number Of Medicare Beneficiaries With Drug Services | 239 |
| Total Drug Submitted ChargeAmount | 6928.87 |
| Total Drug Medicare AllowedAmount | 4898.71 |
| Total Drug Medicare PaymentAmount | 3809.3 |
| Total Drug Medicare Standardized Payment Amount | 3809.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 7923 |
| Number Of Medicare Beneficiaries With Medical Services | 4230 |
| Total Medical Submitted Charge Amount | 4710233.98 |
| Total Medical Medicare Allowed Amount | 805649.89 |
| Total Medical Medicare Payment Amount | 613694.25 |
| Total Medical Medicare Standardized Payment Amount | 546624.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 285 |
| Number Of Beneficiaries Age 65 to 74 | 1976 |
| Number Of Beneficiaries Age 75 to 84 | 1405 |
| Number Of Beneficiaries Age Greater 84 | 566 |
| Number Of Female Beneficiaries | 2503 |
| Number Of Male Beneficiaries | 1729 |
| Number Of Non Hispanic White Beneficiaries | 3484 |
| Number Of Black or African American Beneficiaries | 253 |
| Number Of AsianPacific Islander Beneficiaries | 183 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 159 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3369 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 863 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1644 |