| National Provider Identifier [NPI]: | 1285781153 |
| Last Name Of The Provider | MOCK-MUHAMMAD |
| First Name Of The Provider | BERTHRONE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 971 LAKELAND DRIVE |
| Street Address 2 Of The Provider | JACKSON |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164608 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 4099 |
| Number Of Medicare Beneficiaries | 1387 |
| Total Submitted Charge Amount | 983737.56 |
| Total Medicare Allowed Amount | 370440.75 |
| Total Medicare Payment Amount | 282452.97 |
| Total Medicare Standardized Payment Amount | 301823.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 284 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 33625.5 |
| Total Drug Medicare AllowedAmount | 14983.11 |
| Total Drug Medicare PaymentAmount | 11679.94 |
| Total Drug Medicare Standardized Payment Amount | 11679.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 3815 |
| Number Of Medicare Beneficiaries With Medical Services | 1387 |
| Total Medical Submitted Charge Amount | 950112.06 |
| Total Medical Medicare Allowed Amount | 355457.64 |
| Total Medical Medicare Payment Amount | 270773.03 |
| Total Medical Medicare Standardized Payment Amount | 290143.14 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 349 |
| Number Of Beneficiaries Age 65 to 74 | 462 |
| Number Of Beneficiaries Age 75 to 84 | 356 |
| Number Of Beneficiaries Age Greater 84 | 220 |
| Number Of Female Beneficiaries | 824 |
| Number Of Male Beneficiaries | 563 |
| Number Of Non Hispanic White Beneficiaries | 590 |
| Number Of Black or African American Beneficiaries | 784 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 626 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1485 |