| National Provider Identifier [NPI]: | 1003893595 |
| Last Name Of The Provider | MISTRY |
| First Name Of The Provider | VIJAY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6770 MAYFIELD RD # 425 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MAYFIELD HTS |
| Zip Code Of The Provider | 441242299 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 9243 |
| Number Of Medicare Beneficiaries | 2375 |
| Total Submitted Charge Amount | 935353 |
| Total Medicare Allowed Amount | 562523.33 |
| Total Medicare Payment Amount | 434389.52 |
| Total Medicare Standardized Payment Amount | 445165.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 821 |
| Total Drug Medicare AllowedAmount | 278.2 |
| Total Drug Medicare PaymentAmount | 271.65 |
| Total Drug Medicare Standardized Payment Amount | 271.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 9218 |
| Number Of Medicare Beneficiaries With Medical Services | 2375 |
| Total Medical Submitted Charge Amount | 934532 |
| Total Medical Medicare Allowed Amount | 562245.13 |
| Total Medical Medicare Payment Amount | 434117.87 |
| Total Medical Medicare Standardized Payment Amount | 444893.52 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 320 |
| Number Of Beneficiaries Age 65 to 74 | 679 |
| Number Of Beneficiaries Age 75 to 84 | 729 |
| Number Of Beneficiaries Age Greater 84 | 647 |
| Number Of Female Beneficiaries | 1306 |
| Number Of Male Beneficiaries | 1069 |
| Number Of Non Hispanic White Beneficiaries | 1748 |
| Number Of Black or African American Beneficiaries | 538 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1719 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 656 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2731 |