| National Provider Identifier [NPI]: | 1811004773 |
| Last Name Of The Provider | MISTRY |
| First Name Of The Provider | DARSHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7255 OLD OAK BLVD # 209 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441303329 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3450 |
| Number Of Medicare Beneficiaries | 659 |
| Total Submitted Charge Amount | 521420 |
| Total Medicare Allowed Amount | 351495.48 |
| Total Medicare Payment Amount | 260413.66 |
| Total Medicare Standardized Payment Amount | 221894.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 1920 |
| Total Drug Medicare AllowedAmount | 713.59 |
| Total Drug Medicare PaymentAmount | 687.43 |
| Total Drug Medicare Standardized Payment Amount | 687.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3382 |
| Number Of Medicare Beneficiaries With Medical Services | 659 |
| Total Medical Submitted Charge Amount | 519500 |
| Total Medical Medicare Allowed Amount | 350781.89 |
| Total Medical Medicare Payment Amount | 259726.23 |
| Total Medical Medicare Standardized Payment Amount | 221206.6 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 360 |
| Number Of Male Beneficiaries | 299 |
| Number Of Non Hispanic White Beneficiaries | 613 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 539 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.793 |