| National Provider Identifier [NPI]: | 1194709329 |
| Last Name Of The Provider | MANN |
| First Name Of The Provider | BOB |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 775 POPLAR RD |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | NEWNAN |
| Zip Code Of The Provider | 302658300 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 3008 |
| Number Of Medicare Beneficiaries | 585 |
| Total Submitted Charge Amount | 513849.4 |
| Total Medicare Allowed Amount | 152084.21 |
| Total Medicare Payment Amount | 109257.75 |
| Total Medicare Standardized Payment Amount | 116469.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 86 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 133960 |
| Total Drug Medicare AllowedAmount | 15685.28 |
| Total Drug Medicare PaymentAmount | 12097.09 |
| Total Drug Medicare Standardized Payment Amount | 12097.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 2922 |
| Number Of Medicare Beneficiaries With Medical Services | 585 |
| Total Medical Submitted Charge Amount | 379889.4 |
| Total Medical Medicare Allowed Amount | 136398.93 |
| Total Medical Medicare Payment Amount | 97160.66 |
| Total Medical Medicare Standardized Payment Amount | 104372.36 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 241 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 116 |
| Number Of Male Beneficiaries | 469 |
| Number Of Non Hispanic White Beneficiaries | 525 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 553 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0588 |