| National Provider Identifier [NPI]: | 1184667024 |
| Last Name Of The Provider | MIHM |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 512 NOKOMIS AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342852817 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 278 |
| Number Of Services | 81868 |
| Number Of Medicare Beneficiaries | 6219 |
| Total Submitted Charge Amount | 1324661.02 |
| Total Medicare Allowed Amount | 1111106.82 |
| Total Medicare Payment Amount | 887931.73 |
| Total Medicare Standardized Payment Amount | 914535.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 70314 |
| Number Of Medicare Beneficiaries With Drug Services | 776 |
| Total Drug Submitted ChargeAmount | 46038.85 |
| Total Drug Medicare AllowedAmount | 17385.93 |
| Total Drug Medicare PaymentAmount | 13524.75 |
| Total Drug Medicare Standardized Payment Amount | 13524.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 264 |
| Number Of Medical Services | 11554 |
| Number Of Medicare Beneficiaries With Medical Services | 6219 |
| Total Medical Submitted Charge Amount | 1278622.17 |
| Total Medical Medicare Allowed Amount | 1093720.89 |
| Total Medical Medicare Payment Amount | 874406.98 |
| Total Medical Medicare Standardized Payment Amount | 901011.03 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 290 |
| Number Of Beneficiaries Age 65 to 74 | 2447 |
| Number Of Beneficiaries Age 75 to 84 | 2325 |
| Number Of Beneficiaries Age Greater 84 | 1157 |
| Number Of Female Beneficiaries | 3969 |
| Number Of Male Beneficiaries | 2250 |
| Number Of Non Hispanic White Beneficiaries | 6028 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5850 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 369 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3124 |