| National Provider Identifier [NPI]: | 1376738286 |
| Last Name Of The Provider | MANEEVESE |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4801 ALBERTA AVENUE |
| Street Address 2 Of The Provider | SUITE B3200 |
| City Of The Provider | EL PASO |
| Zip Code Of The Provider | 79905 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 391 |
| Number Of Medicare Beneficiaries | 353 |
| Total Submitted Charge Amount | 569574 |
| Total Medicare Allowed Amount | 61843.9 |
| Total Medicare Payment Amount | 47094.8 |
| Total Medicare Standardized Payment Amount | 47051.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 391 |
| Number Of Medicare Beneficiaries With Medical Services | 353 |
| Total Medical Submitted Charge Amount | 569574 |
| Total Medical Medicare Allowed Amount | 61843.9 |
| Total Medical Medicare Payment Amount | 47094.8 |
| Total Medical Medicare Standardized Payment Amount | 47051.54 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 149 |
| Number Of Non Hispanic White Beneficiaries | 164 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 95 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 186 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.6763 |