| National Provider Identifier [NPI]: | 1356441968 |
| Last Name Of The Provider | MEDINA |
| First Name Of The Provider | MIGUEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4420 S HOPKINS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TITUSVILLE |
| Zip Code Of The Provider | 327806690 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 2291 |
| Number Of Medicare Beneficiaries | 476 |
| Total Submitted Charge Amount | 330957.2 |
| Total Medicare Allowed Amount | 209578.2 |
| Total Medicare Payment Amount | 149949.18 |
| Total Medicare Standardized Payment Amount | 149837.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1065 |
| Total Drug Medicare AllowedAmount | 494.38 |
| Total Drug Medicare PaymentAmount | 464.47 |
| Total Drug Medicare Standardized Payment Amount | 464.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 2230 |
| Number Of Medicare Beneficiaries With Medical Services | 476 |
| Total Medical Submitted Charge Amount | 329892.2 |
| Total Medical Medicare Allowed Amount | 209083.82 |
| Total Medical Medicare Payment Amount | 149484.71 |
| Total Medical Medicare Standardized Payment Amount | 149372.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 398 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6786 |