| National Provider Identifier [NPI]: | 1235101304 |
| Last Name Of The Provider | VICIANA |
| First Name Of The Provider | ANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5000 UNIVERSITY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORAL GABLES |
| Zip Code Of The Provider | 331462008 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 6329 |
| Number Of Medicare Beneficiaries | 2872 |
| Total Submitted Charge Amount | 982905 |
| Total Medicare Allowed Amount | 277050.63 |
| Total Medicare Payment Amount | 215864.69 |
| Total Medicare Standardized Payment Amount | 159843.65 |
| 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 | 33 |
| Number Of Medical Services | 6329 |
| Number Of Medicare Beneficiaries With Medical Services | 2872 |
| Total Medical Submitted Charge Amount | 982905 |
| Total Medical Medicare Allowed Amount | 277050.63 |
| Total Medical Medicare Payment Amount | 215864.69 |
| Total Medical Medicare Standardized Payment Amount | 159843.65 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 1363 |
| Number Of Beneficiaries Age 75 to 84 | 935 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1542 |
| Number Of Male Beneficiaries | 1330 |
| Number Of Non Hispanic White Beneficiaries | 2169 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 608 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2330 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2415 |