| National Provider Identifier [NPI]: | 1609040401 |
| Last Name Of The Provider | MANGALAT |
| First Name Of The Provider | DEV |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 JESSE JEWELL PKWY SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013834 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 5522 |
| Number Of Medicare Beneficiaries | 981 |
| Total Submitted Charge Amount | 2183433.25 |
| Total Medicare Allowed Amount | 555348.91 |
| Total Medicare Payment Amount | 429033.54 |
| Total Medicare Standardized Payment Amount | 467879.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 3030 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 3178 |
| Total Drug Medicare AllowedAmount | 600.33 |
| Total Drug Medicare PaymentAmount | 470.66 |
| Total Drug Medicare Standardized Payment Amount | 470.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 2492 |
| Number Of Medicare Beneficiaries With Medical Services | 981 |
| Total Medical Submitted Charge Amount | 2180255.25 |
| Total Medical Medicare Allowed Amount | 554748.58 |
| Total Medical Medicare Payment Amount | 428562.88 |
| Total Medical Medicare Standardized Payment Amount | 467408.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 341 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 542 |
| Number Of Male Beneficiaries | 439 |
| Number Of Non Hispanic White Beneficiaries | 900 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 738 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 243 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8772 |