| National Provider Identifier [NPI]: | 1205854015 |
| Last Name Of The Provider | HUSSAIN |
| First Name Of The Provider | IFTIKHAR |
| 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 | 7307 S YALE AVE |
| Street Address 2 Of The Provider | SUITE: 200 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741367049 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 16866 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 848380.17 |
| Total Medicare Allowed Amount | 442194.26 |
| Total Medicare Payment Amount | 344727.9 |
| Total Medicare Standardized Payment Amount | 337006.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 12073.5 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 546218.02 |
| Total Drug Medicare AllowedAmount | 351469.31 |
| Total Drug Medicare PaymentAmount | 275518.51 |
| Total Drug Medicare Standardized Payment Amount | 275518.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 4792.5 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 302162.15 |
| Total Medical Medicare Allowed Amount | 90724.95 |
| Total Medical Medicare Payment Amount | 69209.39 |
| Total Medical Medicare Standardized Payment Amount | 61487.66 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 74 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 37 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1978 |