| National Provider Identifier [NPI]: | 1023058302 |
| Last Name Of The Provider | AHMED |
| First Name Of The Provider | MANSOOR |
| 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 | 789 EASTERN BYP |
| Street Address 2 Of The Provider | SUITE 17 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 404752415 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 2287 |
| Number Of Medicare Beneficiaries | 632 |
| Total Submitted Charge Amount | 420078.47 |
| Total Medicare Allowed Amount | 180764.65 |
| Total Medicare Payment Amount | 124774.25 |
| Total Medicare Standardized Payment Amount | 137479.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 494 |
| Number Of Medicare Beneficiaries With Drug Services | 126 |
| Total Drug Submitted ChargeAmount | 28762.5 |
| Total Drug Medicare AllowedAmount | 9013.85 |
| Total Drug Medicare PaymentAmount | 7046.16 |
| Total Drug Medicare Standardized Payment Amount | 7046.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 1793 |
| Number Of Medicare Beneficiaries With Medical Services | 632 |
| Total Medical Submitted Charge Amount | 391315.97 |
| Total Medical Medicare Allowed Amount | 171750.8 |
| Total Medical Medicare Payment Amount | 117728.09 |
| Total Medical Medicare Standardized Payment Amount | 130432.87 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 264 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 490 |
| Number Of Male Beneficiaries | 142 |
| Number Of Non Hispanic White Beneficiaries | 613 |
| 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 | 352 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 280 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2813 |