| National Provider Identifier [NPI]: | 1578581112 |
| Last Name Of The Provider | MIDENCE |
| First Name Of The Provider | ROBERT |
| 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 | 3700 EMERGENCY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEBRING |
| Zip Code Of The Provider | 338705536 |
| 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 | 52 |
| Number Of Services | 5170 |
| Number Of Medicare Beneficiaries | 712 |
| Total Submitted Charge Amount | 808311.5 |
| Total Medicare Allowed Amount | 322831.15 |
| Total Medicare Payment Amount | 227977.13 |
| Total Medicare Standardized Payment Amount | 227738.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 851 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 16732.41 |
| Total Drug Medicare AllowedAmount | 12096.19 |
| Total Drug Medicare PaymentAmount | 9786.86 |
| Total Drug Medicare Standardized Payment Amount | 9786.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 4319 |
| Number Of Medicare Beneficiaries With Medical Services | 712 |
| Total Medical Submitted Charge Amount | 791579.09 |
| Total Medical Medicare Allowed Amount | 310734.96 |
| Total Medical Medicare Payment Amount | 218190.27 |
| Total Medical Medicare Standardized Payment Amount | 217951.21 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 194 |
| Number Of Beneficiaries Age 75 to 84 | 315 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 427 |
| Number Of Male Beneficiaries | 285 |
| Number Of Non Hispanic White Beneficiaries | 681 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 689 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1712 |