| National Provider Identifier [NPI]: | 1366484347 |
| Last Name Of The Provider | BAGA |
| First Name Of The Provider | MELECITO |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 512 NOKOMIS AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342852817 |
| 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 | 201 |
| Number Of Services | 39532 |
| Number Of Medicare Beneficiaries | 5747 |
| Total Submitted Charge Amount | 573311.58 |
| Total Medicare Allowed Amount | 485463.7 |
| Total Medicare Payment Amount | 388090.51 |
| Total Medicare Standardized Payment Amount | 398065.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 29227 |
| Number Of Medicare Beneficiaries With Drug Services | 298 |
| Total Drug Submitted ChargeAmount | 11093.6 |
| Total Drug Medicare AllowedAmount | 5806.89 |
| Total Drug Medicare PaymentAmount | 4482.55 |
| Total Drug Medicare Standardized Payment Amount | 4482.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 10305 |
| Number Of Medicare Beneficiaries With Medical Services | 5747 |
| Total Medical Submitted Charge Amount | 562217.98 |
| Total Medical Medicare Allowed Amount | 479656.81 |
| Total Medical Medicare Payment Amount | 383607.96 |
| Total Medical Medicare Standardized Payment Amount | 393582.68 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 271 |
| Number Of Beneficiaries Age 65 to 74 | 2174 |
| Number Of Beneficiaries Age 75 to 84 | 2119 |
| Number Of Beneficiaries Age Greater 84 | 1183 |
| Number Of Female Beneficiaries | 3560 |
| Number Of Male Beneficiaries | 2187 |
| Number Of Non Hispanic White Beneficiaries | 5575 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 404 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.361 |