| National Provider Identifier [NPI]: | 1578528428 |
| Last Name Of The Provider | ANSARI |
| First Name Of The Provider | MOHAMMAD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5606 W NORVELL BRYANT HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRYSTAL RIVER |
| Zip Code Of The Provider | 344297572 |
| 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 | 52 |
| Number Of Services | 7691 |
| Number Of Medicare Beneficiaries | 1769 |
| Total Submitted Charge Amount | 1788893 |
| Total Medicare Allowed Amount | 765823.57 |
| Total Medicare Payment Amount | 572873.39 |
| Total Medicare Standardized Payment Amount | 579873.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 605 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 68970 |
| Total Drug Medicare AllowedAmount | 32037.77 |
| Total Drug Medicare PaymentAmount | 24634.19 |
| Total Drug Medicare Standardized Payment Amount | 24634.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 7086 |
| Number Of Medicare Beneficiaries With Medical Services | 1769 |
| Total Medical Submitted Charge Amount | 1719923 |
| Total Medical Medicare Allowed Amount | 733785.8 |
| Total Medical Medicare Payment Amount | 548239.2 |
| Total Medical Medicare Standardized Payment Amount | 555239.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 606 |
| Number Of Beneficiaries Age 75 to 84 | 750 |
| Number Of Beneficiaries Age Greater 84 | 293 |
| Number Of Female Beneficiaries | 793 |
| Number Of Male Beneficiaries | 976 |
| Number Of Non Hispanic White Beneficiaries | 1654 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 197 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.497 |