| National Provider Identifier [NPI]: | 1306089222 |
| Last Name Of The Provider | MISHRA |
| First Name Of The Provider | MANISH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 106 S CLAUDE A LORD BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | POTTSVILLE |
| Zip Code Of The Provider | 179013602 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 6512 |
| Number Of Medicare Beneficiaries | 843 |
| Total Submitted Charge Amount | 423418.5 |
| Total Medicare Allowed Amount | 336159.96 |
| Total Medicare Payment Amount | 261345.24 |
| Total Medicare Standardized Payment Amount | 238082.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 475 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 16584 |
| Total Drug Medicare AllowedAmount | 9659.85 |
| Total Drug Medicare PaymentAmount | 8569.21 |
| Total Drug Medicare Standardized Payment Amount | 8569.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 6037 |
| Number Of Medicare Beneficiaries With Medical Services | 843 |
| Total Medical Submitted Charge Amount | 406834.5 |
| Total Medical Medicare Allowed Amount | 326500.11 |
| Total Medical Medicare Payment Amount | 252776.03 |
| Total Medical Medicare Standardized Payment Amount | 229513.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 160 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 258 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 483 |
| Number Of Male Beneficiaries | 360 |
| Number Of Non Hispanic White Beneficiaries | 819 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 538 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 305 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8207 |