| National Provider Identifier [NPI]: | 1326016460 |
| Last Name Of The Provider | MANDVIWALA |
| First Name Of The Provider | AQEEL |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1210 W 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LONDON |
| Zip Code Of The Provider | 407412112 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 4842 |
| Number Of Medicare Beneficiaries | 1233 |
| Total Submitted Charge Amount | 689417.38 |
| Total Medicare Allowed Amount | 343825.83 |
| Total Medicare Payment Amount | 268415.91 |
| Total Medicare Standardized Payment Amount | 284186.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 7572.38 |
| Total Drug Medicare AllowedAmount | 3507.82 |
| Total Drug Medicare PaymentAmount | 3406.88 |
| Total Drug Medicare Standardized Payment Amount | 3406.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 4750 |
| Number Of Medicare Beneficiaries With Medical Services | 1233 |
| Total Medical Submitted Charge Amount | 681845 |
| Total Medical Medicare Allowed Amount | 340318.01 |
| Total Medical Medicare Payment Amount | 265009.03 |
| Total Medical Medicare Standardized Payment Amount | 280779.45 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 372 |
| Number Of Beneficiaries Age 65 to 74 | 522 |
| Number Of Beneficiaries Age 75 to 84 | 269 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 653 |
| Number Of Male Beneficiaries | 580 |
| Number Of Non Hispanic White Beneficiaries | 1218 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 602 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9994 |