| National Provider Identifier [NPI]: | 1457341026 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | MINA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1825 N MILLS AVE |
| Street Address 2 Of The Provider | LAKESIDE SIDE SURGERY CENTER |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 32803 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 1584 |
| Number Of Medicare Beneficiaries | 1049 |
| Total Submitted Charge Amount | 1295411.75 |
| Total Medicare Allowed Amount | 205551.37 |
| Total Medicare Payment Amount | 158918.36 |
| Total Medicare Standardized Payment Amount | 154494.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 4 |
| Number Of Medical Services | 1584 |
| Number Of Medicare Beneficiaries With Medical Services | 1049 |
| Total Medical Submitted Charge Amount | 1295411.75 |
| Total Medical Medicare Allowed Amount | 205551.37 |
| Total Medical Medicare Payment Amount | 158918.36 |
| Total Medical Medicare Standardized Payment Amount | 154494.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 510 |
| Number Of Beneficiaries Age 75 to 84 | 391 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 603 |
| Number Of Male Beneficiaries | 446 |
| Number Of Non Hispanic White Beneficiaries | 753 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 121 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 884 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 165 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1848 |