| National Provider Identifier [NPI]: | 1639117252 |
| Last Name Of The Provider | ELMANSOURY |
| First Name Of The Provider | ABDELNASSER |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17222 HOSPITAL BLVD |
| Street Address 2 Of The Provider | SUITE 238 |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346018925 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 10186 |
| Number Of Medicare Beneficiaries | 4928 |
| Total Submitted Charge Amount | 1094465 |
| Total Medicare Allowed Amount | 220515.16 |
| Total Medicare Payment Amount | 171355.6 |
| Total Medicare Standardized Payment Amount | 172662.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 4621 |
| Total Drug Medicare AllowedAmount | 1002.92 |
| Total Drug Medicare PaymentAmount | 786.29 |
| Total Drug Medicare Standardized Payment Amount | 786.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 10032 |
| Number Of Medicare Beneficiaries With Medical Services | 4928 |
| Total Medical Submitted Charge Amount | 1089844 |
| Total Medical Medicare Allowed Amount | 219512.24 |
| Total Medical Medicare Payment Amount | 170569.31 |
| Total Medical Medicare Standardized Payment Amount | 171876.2 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 655 |
| Number Of Beneficiaries Age 65 to 74 | 1609 |
| Number Of Beneficiaries Age 75 to 84 | 1648 |
| Number Of Beneficiaries Age Greater 84 | 1016 |
| Number Of Female Beneficiaries | 2592 |
| Number Of Male Beneficiaries | 2336 |
| Number Of Non Hispanic White Beneficiaries | 4529 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 200 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3968 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 960 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8333 |