| National Provider Identifier [NPI]: | 1750310173 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | MANISH |
| 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 | 1698 E. MCANDREWS RD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 975045590 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 2055 |
| Number Of Medicare Beneficiaries | 983 |
| Total Submitted Charge Amount | 456005 |
| Total Medicare Allowed Amount | 116391.25 |
| Total Medicare Payment Amount | 89779.66 |
| Total Medicare Standardized Payment Amount | 92108.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 2055 |
| Number Of Medicare Beneficiaries With Medical Services | 983 |
| Total Medical Submitted Charge Amount | 456005 |
| Total Medical Medicare Allowed Amount | 116391.25 |
| Total Medical Medicare Payment Amount | 89779.66 |
| Total Medical Medicare Standardized Payment Amount | 92108.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 170 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 286 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 485 |
| Number Of Male Beneficiaries | 498 |
| Number Of Non Hispanic White Beneficiaries | 923 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 710 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 273 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6691 |