| National Provider Identifier [NPI]: | 1649233701 | 
| Last Name Of The Provider | MIKAN | 
| First Name Of The Provider | PAUL | 
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD | 
| Gender Of The Provider | M | 
| Entity Type Of The Provider | I | 
| Street Address 1 Of The Provider | 40 RIPTON RD | 
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTINGTON | 
| Zip Code Of The Provider | 064842637 | 
| State Code Of The Provider | CT | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | Internal Medicine | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 28 | 
| Number Of Services | 1654 | 
| Number Of Medicare Beneficiaries | 422 | 
| Total Submitted Charge Amount | 247059 | 
| Total Medicare Allowed Amount | 122347.64 | 
| Total Medicare Payment Amount | 88157.42 | 
| Total Medicare Standardized Payment Amount | 82479.4 | 
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 | 
| Number Of Drug Services | 106 | 
| Number Of Medicare Beneficiaries With Drug Services | 98 | 
| Total Drug Submitted ChargeAmount | 7760 | 
| Total Drug Medicare AllowedAmount | 4027.82 | 
| Total Drug Medicare PaymentAmount | 3947.06 | 
| Total Drug Medicare Standardized Payment Amount | 3947.06 | 
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 | 
| Number Of Medical Services | 1548 | 
| Number Of Medicare Beneficiaries With Medical Services | 422 | 
| Total Medical Submitted Charge Amount | 239299 | 
| Total Medical Medicare Allowed Amount | 118319.82 | 
| Total Medical Medicare Payment Amount | 84210.36 | 
| Total Medical Medicare Standardized Payment Amount | 78532.34 | 
| Average Age Of Beneficiaries | 75 | 
| Number Of Beneficiaries Age Less65 | 35 | 
| Number Of Beneficiaries Age 65 to 74 | 168 | 
| Number Of Beneficiaries Age 75 to 84 | 151 | 
| Number Of Beneficiaries Age Greater 84 | 68 | 
| Number Of Female Beneficiaries | 230 | 
| Number Of Male Beneficiaries | 192 | 
| Number Of Non Hispanic White Beneficiaries | 389 | 
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 | 
| Number Of American Indian Alaska Native Beneficiaries | 0 | 
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 359 | 
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 | 
| Percent Of With Atrial Fibrillation | 11 | 
| Percent Of With Alzheimers Disease or Dementia | 10 | 
| Percent Of With Asthma | 8 | 
| Percent Of With Cancer | 9 | 
| Percent Of With Heart Failure | 15 | 
| Percent Of With Chronic Kidney Disease | 15 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 | 
| Percent Of With Depression | 13 | 
| Percent Of With Diabetes | 26 | 
| Percent Of With Hyperlipidemia | 52 | 
| Percent Of With Hypertension | 64 | 
| Percent Of With Ischemic Heart Disease | 27 | 
| Percent Of With Osteoporosis | 5 | 
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1457 |