| National Provider Identifier [NPI]: | 1578510681 |
| Last Name Of The Provider | MIRANDA |
| First Name Of The Provider | IMELDA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7611 S OSBORNE RD |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | UPPER MARLBORO |
| Zip Code Of The Provider | 207724200 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 2717 |
| Number Of Medicare Beneficiaries | 456 |
| Total Submitted Charge Amount | 167680.47 |
| Total Medicare Allowed Amount | 137210.97 |
| Total Medicare Payment Amount | 93328.07 |
| Total Medicare Standardized Payment Amount | 85555.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1344 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 36730.47 |
| Total Drug Medicare AllowedAmount | 20942.3 |
| Total Drug Medicare PaymentAmount | 17248.85 |
| Total Drug Medicare Standardized Payment Amount | 17248.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 1373 |
| Number Of Medicare Beneficiaries With Medical Services | 456 |
| Total Medical Submitted Charge Amount | 130950 |
| Total Medical Medicare Allowed Amount | 116268.67 |
| Total Medical Medicare Payment Amount | 76079.22 |
| Total Medical Medicare Standardized Payment Amount | 68306.83 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 243 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 325 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | 255 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8644 |