| National Provider Identifier [NPI]: | 1013997048 |
| Last Name Of The Provider | MIAN |
| First Name Of The Provider | ALEC |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2600 NAVARRE AVE |
| Street Address 2 Of The Provider | ST CHARLES MERCY HOSPITAL |
| City Of The Provider | OREGON |
| Zip Code Of The Provider | 436163297 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1768 |
| Number Of Medicare Beneficiaries | 689 |
| Total Submitted Charge Amount | 279634 |
| Total Medicare Allowed Amount | 59400.72 |
| Total Medicare Payment Amount | 44893.02 |
| Total Medicare Standardized Payment Amount | 34483.77 |
| 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 | 39 |
| Number Of Medical Services | 1768 |
| Number Of Medicare Beneficiaries With Medical Services | 689 |
| Total Medical Submitted Charge Amount | 279634 |
| Total Medical Medicare Allowed Amount | 59400.72 |
| Total Medical Medicare Payment Amount | 44893.02 |
| Total Medical Medicare Standardized Payment Amount | 34483.77 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 282 |
| Number Of Beneficiaries Age 75 to 84 | 178 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 584 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 485 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 204 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7061 |