| National Provider Identifier [NPI]: | 1265422794 |
| Last Name Of The Provider | MICOVIC |
| First Name Of The Provider | VELIMIR |
| 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 | 23 BARKLEY CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339077531 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 15868 |
| Number Of Medicare Beneficiaries | 1714 |
| Total Submitted Charge Amount | 4015648.14 |
| Total Medicare Allowed Amount | 850162.1 |
| Total Medicare Payment Amount | 640505.12 |
| Total Medicare Standardized Payment Amount | 586701.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 7165 |
| Number Of Medicare Beneficiaries With Drug Services | 293 |
| Total Drug Submitted ChargeAmount | 271344.14 |
| Total Drug Medicare AllowedAmount | 17429.91 |
| Total Drug Medicare PaymentAmount | 13532.3 |
| Total Drug Medicare Standardized Payment Amount | 13532.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 8703 |
| Number Of Medicare Beneficiaries With Medical Services | 1713 |
| Total Medical Submitted Charge Amount | 3744304 |
| Total Medical Medicare Allowed Amount | 832732.19 |
| Total Medical Medicare Payment Amount | 626972.82 |
| Total Medical Medicare Standardized Payment Amount | 573169.45 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 491 |
| Number Of Beneficiaries Age 65 to 74 | 598 |
| Number Of Beneficiaries Age 75 to 84 | 449 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 987 |
| Number Of Male Beneficiaries | 727 |
| Number Of Non Hispanic White Beneficiaries | 1547 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7128 |