| National Provider Identifier [NPI]: | 1790728178 |
| Last Name Of The Provider | VENINCASA |
| First Name Of The Provider | MICHAEL |
| 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 | 851 HIGHWAY 287 N |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANSFIELD |
| Zip Code Of The Provider | 760632634 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 6527 |
| Number Of Medicare Beneficiaries | 3291 |
| Total Submitted Charge Amount | 460131.68 |
| Total Medicare Allowed Amount | 216140.05 |
| Total Medicare Payment Amount | 164283.03 |
| Total Medicare Standardized Payment Amount | 161836.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 139 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 7202.68 |
| Total Drug Medicare AllowedAmount | 7167.19 |
| Total Drug Medicare PaymentAmount | 5619.16 |
| Total Drug Medicare Standardized Payment Amount | 5619.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 6388 |
| Number Of Medicare Beneficiaries With Medical Services | 3291 |
| Total Medical Submitted Charge Amount | 452929 |
| Total Medical Medicare Allowed Amount | 208972.86 |
| Total Medical Medicare Payment Amount | 158663.87 |
| Total Medical Medicare Standardized Payment Amount | 156217.65 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 733 |
| Number Of Beneficiaries Age 65 to 74 | 1125 |
| Number Of Beneficiaries Age 75 to 84 | 927 |
| Number Of Beneficiaries Age Greater 84 | 506 |
| Number Of Female Beneficiaries | 2007 |
| Number Of Male Beneficiaries | 1284 |
| Number Of Non Hispanic White Beneficiaries | 1762 |
| Number Of Black or African American Beneficiaries | 1213 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 233 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1093 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.4439 |