| National Provider Identifier [NPI]: | 1407836158 |
| Last Name Of The Provider | SHIVPRASAD |
| First Name Of The Provider | MINI |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1240 JESSE JEWELL PKWY SE |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013862 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 11612 |
| Number Of Medicare Beneficiaries | 607 |
| Total Submitted Charge Amount | 1006977 |
| Total Medicare Allowed Amount | 360623.03 |
| Total Medicare Payment Amount | 277962.5 |
| Total Medicare Standardized Payment Amount | 294612.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 519 |
| Number Of Medicare Beneficiaries With Drug Services | 267 |
| Total Drug Submitted ChargeAmount | 14894 |
| Total Drug Medicare AllowedAmount | 8043.4 |
| Total Drug Medicare PaymentAmount | 7527.84 |
| Total Drug Medicare Standardized Payment Amount | 7527.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 11093 |
| Number Of Medicare Beneficiaries With Medical Services | 607 |
| Total Medical Submitted Charge Amount | 992083 |
| Total Medical Medicare Allowed Amount | 352579.63 |
| Total Medical Medicare Payment Amount | 270434.66 |
| Total Medical Medicare Standardized Payment Amount | 287084.94 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 211 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 492 |
| Number Of Male Beneficiaries | 115 |
| Number Of Non Hispanic White Beneficiaries | 574 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1172 |