| National Provider Identifier [NPI]: | 1821252305 |
| Last Name Of The Provider | JIANG |
| First Name Of The Provider | MANLI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2785 WHITE BEAR AVE, |
| Street Address 2 Of The Provider | STE 108 B |
| City Of The Provider | MAPLEWOOD |
| Zip Code Of The Provider | 55109 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 7782 |
| Number Of Medicare Beneficiaries | 561 |
| Total Submitted Charge Amount | 1666169 |
| Total Medicare Allowed Amount | 672276.24 |
| Total Medicare Payment Amount | 522365.53 |
| Total Medicare Standardized Payment Amount | 485403.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3927 |
| Number Of Medicare Beneficiaries With Drug Services | 540 |
| Total Drug Submitted ChargeAmount | 616694 |
| Total Drug Medicare AllowedAmount | 192374.3 |
| Total Drug Medicare PaymentAmount | 148761.25 |
| Total Drug Medicare Standardized Payment Amount | 148761.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 3855 |
| Number Of Medicare Beneficiaries With Medical Services | 561 |
| Total Medical Submitted Charge Amount | 1049475 |
| Total Medical Medicare Allowed Amount | 479901.94 |
| Total Medical Medicare Payment Amount | 373604.28 |
| Total Medical Medicare Standardized Payment Amount | 336642.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 270 |
| Number Of Beneficiaries Age 75 to 84 | 166 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 504 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8531 |