| National Provider Identifier [NPI]: | 1619955671 |
| Last Name Of The Provider | MANI |
| First Name Of The Provider | NISHA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4725 N FEDERAL HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT LAUDERDALE |
| Zip Code Of The Provider | 333084603 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 4919 |
| Number Of Medicare Beneficiaries | 2706 |
| Total Submitted Charge Amount | 448770 |
| Total Medicare Allowed Amount | 150321.14 |
| Total Medicare Payment Amount | 112988.08 |
| Total Medicare Standardized Payment Amount | 106407.76 |
| 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 | 179 |
| Number Of Medical Services | 4919 |
| Number Of Medicare Beneficiaries With Medical Services | 2706 |
| Total Medical Submitted Charge Amount | 448770 |
| Total Medical Medicare Allowed Amount | 150321.14 |
| Total Medical Medicare Payment Amount | 112988.08 |
| Total Medical Medicare Standardized Payment Amount | 106407.76 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 413 |
| Number Of Beneficiaries Age 65 to 74 | 739 |
| Number Of Beneficiaries Age 75 to 84 | 889 |
| Number Of Beneficiaries Age Greater 84 | 665 |
| Number Of Female Beneficiaries | 1647 |
| Number Of Male Beneficiaries | 1059 |
| Number Of Non Hispanic White Beneficiaries | 408 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 2194 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 666 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2040 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.4035 |