| National Provider Identifier [NPI]: | 1831283936 |
| Last Name Of The Provider | MALISH |
| First Name Of The Provider | HAVEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1739 E BEVERLY AVE |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | KINGMAN |
| Zip Code Of The Provider | 864093593 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3152 |
| Number Of Medicare Beneficiaries | 960 |
| Total Submitted Charge Amount | 1085367 |
| Total Medicare Allowed Amount | 295816.4 |
| Total Medicare Payment Amount | 224860.5 |
| Total Medicare Standardized Payment Amount | 227759.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 778 |
| Total Drug Medicare AllowedAmount | 408.77 |
| Total Drug Medicare PaymentAmount | 383.21 |
| Total Drug Medicare Standardized Payment Amount | 383.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 3095 |
| Number Of Medicare Beneficiaries With Medical Services | 960 |
| Total Medical Submitted Charge Amount | 1084589 |
| Total Medical Medicare Allowed Amount | 295407.63 |
| Total Medical Medicare Payment Amount | 224477.29 |
| Total Medical Medicare Standardized Payment Amount | 227375.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 139 |
| Number Of Beneficiaries Age 65 to 74 | 453 |
| Number Of Beneficiaries Age 75 to 84 | 285 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 486 |
| Number Of Male Beneficiaries | 474 |
| Number Of Non Hispanic White Beneficiaries | 893 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 773 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 187 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 64 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.764 |