| National Provider Identifier [NPI]: | 1952463895 |
| Last Name Of The Provider | MANSOURA |
| First Name Of The Provider | AHED |
| 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 | 1825 MARTHA BERRY BLVD NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROME |
| Zip Code Of The Provider | 301651625 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 113640 |
| Number Of Medicare Beneficiaries | 1287 |
| Total Submitted Charge Amount | 3165371 |
| Total Medicare Allowed Amount | 1539249.16 |
| Total Medicare Payment Amount | 1154695.52 |
| Total Medicare Standardized Payment Amount | 1183652.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 49 |
| Number Of Drug Services | 100920 |
| Number Of Medicare Beneficiaries With Drug Services | 389 |
| Total Drug Submitted ChargeAmount | 2128474 |
| Total Drug Medicare AllowedAmount | 1092525.36 |
| Total Drug Medicare PaymentAmount | 825617.12 |
| Total Drug Medicare Standardized Payment Amount | 825617.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 12720 |
| Number Of Medicare Beneficiaries With Medical Services | 1286 |
| Total Medical Submitted Charge Amount | 1036897 |
| Total Medical Medicare Allowed Amount | 446723.8 |
| Total Medical Medicare Payment Amount | 329078.4 |
| Total Medical Medicare Standardized Payment Amount | 358035.33 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 388 |
| Number Of Beneficiaries Age 65 to 74 | 522 |
| Number Of Beneficiaries Age 75 to 84 | 306 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 808 |
| Number Of Male Beneficiaries | 479 |
| Number Of Non Hispanic White Beneficiaries | 1115 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 919 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 368 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5714 |