| National Provider Identifier [NPI]: | 1548207814 |
| Last Name Of The Provider | MOUSSA |
| First Name Of The Provider | ALI |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12697 E 51ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741466236 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 227 |
| Number Of Services | 249726 |
| Number Of Medicare Beneficiaries | 1789 |
| Total Submitted Charge Amount | 11633091 |
| Total Medicare Allowed Amount | 4666297.23 |
| Total Medicare Payment Amount | 3647474.81 |
| Total Medicare Standardized Payment Amount | 3713605.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 96 |
| Number Of Drug Services | 233842 |
| Number Of Medicare Beneficiaries With Drug Services | 577 |
| Total Drug Submitted ChargeAmount | 8967849 |
| Total Drug Medicare AllowedAmount | 3741381.35 |
| Total Drug Medicare PaymentAmount | 2928775.88 |
| Total Drug Medicare Standardized Payment Amount | 2928775.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 15884 |
| Number Of Medicare Beneficiaries With Medical Services | 1787 |
| Total Medical Submitted Charge Amount | 2665242 |
| Total Medical Medicare Allowed Amount | 924915.88 |
| Total Medical Medicare Payment Amount | 718698.93 |
| Total Medical Medicare Standardized Payment Amount | 784829.94 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 250 |
| Number Of Beneficiaries Age 65 to 74 | 799 |
| Number Of Beneficiaries Age 75 to 84 | 600 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 1057 |
| Number Of Male Beneficiaries | 732 |
| Number Of Non Hispanic White Beneficiaries | 1449 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 207 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 362 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 53 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.9834 |