| National Provider Identifier [NPI]: | 1255494092 |
| Last Name Of The Provider | MEDINA |
| First Name Of The Provider | TYRONE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 8TH ST N |
| Street Address 2 Of The Provider | |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341025519 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 11061 |
| Number Of Medicare Beneficiaries | 2076 |
| Total Submitted Charge Amount | 1208102.44 |
| Total Medicare Allowed Amount | 593952.77 |
| Total Medicare Payment Amount | 414078.59 |
| Total Medicare Standardized Payment Amount | 397776.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 1485 |
| Number Of Medicare Beneficiaries With Drug Services | 554 |
| Total Drug Submitted ChargeAmount | 23946.75 |
| Total Drug Medicare AllowedAmount | 5993.38 |
| Total Drug Medicare PaymentAmount | 5210.08 |
| Total Drug Medicare Standardized Payment Amount | 5210.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 9576 |
| Number Of Medicare Beneficiaries With Medical Services | 2076 |
| Total Medical Submitted Charge Amount | 1184155.69 |
| Total Medical Medicare Allowed Amount | 587959.39 |
| Total Medical Medicare Payment Amount | 408868.51 |
| Total Medical Medicare Standardized Payment Amount | 392566.05 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 800 |
| Number Of Beneficiaries Age 75 to 84 | 788 |
| Number Of Beneficiaries Age Greater 84 | 420 |
| Number Of Female Beneficiaries | 1171 |
| Number Of Male Beneficiaries | 905 |
| Number Of Non Hispanic White Beneficiaries | 1927 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1880 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2068 |