| National Provider Identifier [NPI]: | 1578774949 |
| Last Name Of The Provider | ANSARI |
| First Name Of The Provider | HOSSEIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 WHITE POND DRIVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | AKRON |
| Zip Code Of The Provider | 44320 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 5767 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 284296.64 |
| Total Medicare Allowed Amount | 113302.75 |
| Total Medicare Payment Amount | 87282.41 |
| Total Medicare Standardized Payment Amount | 89099.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 5268 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 161026.64 |
| Total Drug Medicare AllowedAmount | 65907.12 |
| Total Drug Medicare PaymentAmount | 51555.37 |
| Total Drug Medicare Standardized Payment Amount | 51555.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 499 |
| Number Of Medicare Beneficiaries With Medical Services | 274 |
| Total Medical Submitted Charge Amount | 123270 |
| Total Medical Medicare Allowed Amount | 47395.63 |
| Total Medical Medicare Payment Amount | 35727.04 |
| Total Medical Medicare Standardized Payment Amount | 37543.73 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 219 |
| Number Of Black or African American Beneficiaries | |
| 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 | 172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 39 |
| Average HCC Risk Score Of Beneficiaries | 2.1467 |