| National Provider Identifier [NPI]: | 1326082397 |
| Last Name Of The Provider | MIRE |
| First Name Of The Provider | BLANE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 46 SERGEANT PRENTISS DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | NATCHEZ |
| Zip Code Of The Provider | 391204725 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 9254 |
| Number Of Medicare Beneficiaries | 720 |
| Total Submitted Charge Amount | 513696 |
| Total Medicare Allowed Amount | 296870.83 |
| Total Medicare Payment Amount | 222982.03 |
| Total Medicare Standardized Payment Amount | 238516.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 5067 |
| Number Of Medicare Beneficiaries With Drug Services | 271 |
| Total Drug Submitted ChargeAmount | 116857 |
| Total Drug Medicare AllowedAmount | 69576.04 |
| Total Drug Medicare PaymentAmount | 54645.93 |
| Total Drug Medicare Standardized Payment Amount | 54645.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 4187 |
| Number Of Medicare Beneficiaries With Medical Services | 720 |
| Total Medical Submitted Charge Amount | 396839 |
| Total Medical Medicare Allowed Amount | 227294.79 |
| Total Medical Medicare Payment Amount | 168336.1 |
| Total Medical Medicare Standardized Payment Amount | 183870.84 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 487 |
| Number Of Male Beneficiaries | 233 |
| Number Of Non Hispanic White Beneficiaries | 529 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 597 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8962 |