| National Provider Identifier [NPI]: | 1023046562 |
| Last Name Of The Provider | MITTAL |
| First Name Of The Provider | RAKESH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5880 49TH ST N |
| Street Address 2 Of The Provider | SUITE N105 |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337092150 |
| 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 | 25 |
| Number Of Services | 3578 |
| Number Of Medicare Beneficiaries | 494 |
| Total Submitted Charge Amount | 554355 |
| Total Medicare Allowed Amount | 318287.66 |
| Total Medicare Payment Amount | 242402.02 |
| Total Medicare Standardized Payment Amount | 241989.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1275 |
| Total Drug Medicare AllowedAmount | 502 |
| Total Drug Medicare PaymentAmount | 489.13 |
| Total Drug Medicare Standardized Payment Amount | 489.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 3539 |
| Number Of Medicare Beneficiaries With Medical Services | 494 |
| Total Medical Submitted Charge Amount | 553080 |
| Total Medical Medicare Allowed Amount | 317785.66 |
| Total Medical Medicare Payment Amount | 241912.89 |
| Total Medical Medicare Standardized Payment Amount | 241500.7 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 193 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 461 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 193 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9138 |