| National Provider Identifier [NPI]: | 1194846394 |
| Last Name Of The Provider | FERNANDO |
| First Name Of The Provider | NILUSHA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1865 VETERANS PARK DR |
| Street Address 2 Of The Provider | STE. 101 |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341090447 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 5239 |
| Number Of Medicare Beneficiaries | 435 |
| Total Submitted Charge Amount | 660281.1 |
| Total Medicare Allowed Amount | 396107.81 |
| Total Medicare Payment Amount | 304185.41 |
| Total Medicare Standardized Payment Amount | 285624.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 522 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 4311.1 |
| Total Drug Medicare AllowedAmount | 1159.99 |
| Total Drug Medicare PaymentAmount | 897.14 |
| Total Drug Medicare Standardized Payment Amount | 897.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 4717 |
| Number Of Medicare Beneficiaries With Medical Services | 435 |
| Total Medical Submitted Charge Amount | 655970 |
| Total Medical Medicare Allowed Amount | 394947.82 |
| Total Medical Medicare Payment Amount | 303288.27 |
| Total Medical Medicare Standardized Payment Amount | 284727.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 194 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 407 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 405 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1498 |