| National Provider Identifier [NPI]: | 1871586453 |
| Last Name Of The Provider | PACHA |
| First Name Of The Provider | MAMOUN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16 S DOUGLAS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SYLACAUGA |
| Zip Code Of The Provider | 351502951 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 2497 |
| Number Of Medicare Beneficiaries | 624 |
| Total Submitted Charge Amount | 441344.52 |
| Total Medicare Allowed Amount | 206476.96 |
| Total Medicare Payment Amount | 154105.41 |
| Total Medicare Standardized Payment Amount | 165688.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 173 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 81850 |
| Total Drug Medicare AllowedAmount | 28185.18 |
| Total Drug Medicare PaymentAmount | 22003.72 |
| Total Drug Medicare Standardized Payment Amount | 22003.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 2324 |
| Number Of Medicare Beneficiaries With Medical Services | 624 |
| Total Medical Submitted Charge Amount | 359494.52 |
| Total Medical Medicare Allowed Amount | 178291.78 |
| Total Medical Medicare Payment Amount | 132101.69 |
| Total Medical Medicare Standardized Payment Amount | 143684.64 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 243 |
| Number Of Beneficiaries Age 75 to 84 | 183 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 208 |
| Number Of Male Beneficiaries | 416 |
| Number Of Non Hispanic White Beneficiaries | 461 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 474 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1474 |