| National Provider Identifier [NPI]: | 1811191794 |
| Last Name Of The Provider | FOTEH |
| First Name Of The Provider | MAZIN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1010 W 40TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787564010 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 10059 |
| Number Of Medicare Beneficiaries | 488 |
| Total Submitted Charge Amount | 4706500.96 |
| Total Medicare Allowed Amount | 1541897.39 |
| Total Medicare Payment Amount | 1185762.5 |
| Total Medicare Standardized Payment Amount | 1190804.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 7660 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 4596 |
| Total Drug Medicare AllowedAmount | 1465.13 |
| Total Drug Medicare PaymentAmount | 1137.72 |
| Total Drug Medicare Standardized Payment Amount | 1137.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 2399 |
| Number Of Medicare Beneficiaries With Medical Services | 488 |
| Total Medical Submitted Charge Amount | 4701904.96 |
| Total Medical Medicare Allowed Amount | 1540432.26 |
| Total Medical Medicare Payment Amount | 1184624.78 |
| Total Medical Medicare Standardized Payment Amount | 1189667 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 174 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 281 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | 106 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 133 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 312 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 5.1824 |