| National Provider Identifier [NPI]: | 1558395681 |
| Last Name Of The Provider | BUSHAN |
| First Name Of The Provider | LAKSHMI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4755 SUMMERLIN RD |
| Street Address 2 Of The Provider | SUITE 8 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339191073 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1133 |
| Number Of Medicare Beneficiaries | 233 |
| Total Submitted Charge Amount | 167994.34 |
| Total Medicare Allowed Amount | 128031.99 |
| Total Medicare Payment Amount | 88194.53 |
| Total Medicare Standardized Payment Amount | 84342.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 440 |
| Total Drug Medicare AllowedAmount | 440 |
| Total Drug Medicare PaymentAmount | 431.2 |
| Total Drug Medicare Standardized Payment Amount | 431.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1111 |
| Number Of Medicare Beneficiaries With Medical Services | 233 |
| Total Medical Submitted Charge Amount | 167554.34 |
| Total Medical Medicare Allowed Amount | 127591.99 |
| Total Medical Medicare Payment Amount | 87763.33 |
| Total Medical Medicare Standardized Payment Amount | 83911.7 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 59 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | 159 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5143 |