| National Provider Identifier [NPI]: | 1568480655 |
| Last Name Of The Provider | JAIN |
| First Name Of The Provider | MANUEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 141 WEBB DR STE 200 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAVENPORT |
| Zip Code Of The Provider | 338373955 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2680 |
| Number Of Medicare Beneficiaries | 294 |
| Total Submitted Charge Amount | 206041 |
| Total Medicare Allowed Amount | 159655.39 |
| Total Medicare Payment Amount | 114854.54 |
| Total Medicare Standardized Payment Amount | 111227.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 1940 |
| Total Drug Medicare AllowedAmount | 1081.93 |
| Total Drug Medicare PaymentAmount | 1055.94 |
| Total Drug Medicare Standardized Payment Amount | 1055.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2616 |
| Number Of Medicare Beneficiaries With Medical Services | 294 |
| Total Medical Submitted Charge Amount | 204101 |
| Total Medical Medicare Allowed Amount | 158573.46 |
| Total Medical Medicare Payment Amount | 113798.6 |
| Total Medical Medicare Standardized Payment Amount | 110171.2 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 243 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 226 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3807 |