| National Provider Identifier [NPI]: | 1215973540 |
| Last Name Of The Provider | MISHRA |
| First Name Of The Provider | BIBHUTI |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6845 ELM ST STE 700 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MC LEAN |
| Zip Code Of The Provider | 221013851 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 6881 |
| Number Of Medicare Beneficiaries | 401 |
| Total Submitted Charge Amount | 347074 |
| Total Medicare Allowed Amount | 220684.83 |
| Total Medicare Payment Amount | 163863.21 |
| Total Medicare Standardized Payment Amount | 152570.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5635 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 65194 |
| Total Drug Medicare AllowedAmount | 44787.02 |
| Total Drug Medicare PaymentAmount | 34563.21 |
| Total Drug Medicare Standardized Payment Amount | 34563.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 1246 |
| Number Of Medicare Beneficiaries With Medical Services | 401 |
| Total Medical Submitted Charge Amount | 281880 |
| Total Medical Medicare Allowed Amount | 175897.81 |
| Total Medical Medicare Payment Amount | 129300 |
| Total Medical Medicare Standardized Payment Amount | 118007.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 232 |
| Number Of Male Beneficiaries | 169 |
| Number Of Non Hispanic White Beneficiaries | 259 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 314 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 26 |
| Average HCC Risk Score Of Beneficiaries | 1.5292 |