| National Provider Identifier [NPI]: | 1255591442 |
| Last Name Of The Provider | MITTAL |
| First Name Of The Provider | MONEESHINDRA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 N LORRAINE ST |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | HUTCHINSON |
| Zip Code Of The Provider | 675015670 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 1033 |
| Number Of Medicare Beneficiaries | 368 |
| Total Submitted Charge Amount | 80858.93 |
| Total Medicare Allowed Amount | 74245.06 |
| Total Medicare Payment Amount | 53628.1 |
| Total Medicare Standardized Payment Amount | 62259.71 |
| 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 | 9 |
| Number Of Medical Services | 1033 |
| Number Of Medicare Beneficiaries With Medical Services | 368 |
| Total Medical Submitted Charge Amount | 80858.93 |
| Total Medical Medicare Allowed Amount | 74245.06 |
| Total Medical Medicare Payment Amount | 53628.1 |
| Total Medical Medicare Standardized Payment Amount | 62259.71 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 238 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 142 |
| Number Of Non Hispanic White Beneficiaries | 347 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 231 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 36 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3728 |