| National Provider Identifier [NPI]: | 1396733895 |
| Last Name Of The Provider | MANSOOR |
| First Name Of The Provider | MOHAMED |
| 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 | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 805 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 4907 |
| Number Of Medicare Beneficiaries | 1782 |
| Total Submitted Charge Amount | 752049 |
| Total Medicare Allowed Amount | 306573.01 |
| Total Medicare Payment Amount | 232694.01 |
| Total Medicare Standardized Payment Amount | 217469.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 209 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 12805 |
| Total Drug Medicare AllowedAmount | 9017.05 |
| Total Drug Medicare PaymentAmount | 7069.29 |
| Total Drug Medicare Standardized Payment Amount | 7069.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 4698 |
| Number Of Medicare Beneficiaries With Medical Services | 1782 |
| Total Medical Submitted Charge Amount | 739244 |
| Total Medical Medicare Allowed Amount | 297555.96 |
| Total Medical Medicare Payment Amount | 225624.72 |
| Total Medical Medicare Standardized Payment Amount | 210399.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 511 |
| Number Of Beneficiaries Age 75 to 84 | 619 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 943 |
| Number Of Male Beneficiaries | 839 |
| Number Of Non Hispanic White Beneficiaries | 1429 |
| Number Of Black or African American Beneficiaries | 144 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 566 |
| Percent Of With Atrial Fibrillation | 36 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0582 |