| National Provider Identifier [NPI]: | 1659371151 |
| Last Name Of The Provider | MAGNO |
| First Name Of The Provider | MANOLO |
| 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 | 3577 W 13 MILE RD |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | ROYAL OAK |
| Zip Code Of The Provider | 480736710 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 158794 |
| Number Of Medicare Beneficiaries | 625 |
| Total Submitted Charge Amount | 3051339.65 |
| Total Medicare Allowed Amount | 1770123.52 |
| Total Medicare Payment Amount | 1386177.6 |
| Total Medicare Standardized Payment Amount | 1375087.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 67 |
| Number Of Drug Services | 150344 |
| Number Of Medicare Beneficiaries With Drug Services | 320 |
| Total Drug Submitted ChargeAmount | 2518711.2 |
| Total Drug Medicare AllowedAmount | 1460299.73 |
| Total Drug Medicare PaymentAmount | 1141339 |
| Total Drug Medicare Standardized Payment Amount | 1141339 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 8450 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 532628.45 |
| Total Medical Medicare Allowed Amount | 309823.79 |
| Total Medical Medicare Payment Amount | 244838.6 |
| Total Medical Medicare Standardized Payment Amount | 233748.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 348 |
| Number Of Male Beneficiaries | 277 |
| Number Of Non Hispanic White Beneficiaries | 533 |
| Number Of Black or African American Beneficiaries | 65 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 567 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.2708 |