| National Provider Identifier [NPI]: | 1124215249 |
| Last Name Of The Provider | ATFEH |
| First Name Of The Provider | MOWAFFAK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11373 CORTEZ BLVD |
| Street Address 2 Of The Provider | SUITE 307 |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346135414 |
| 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 | 73 |
| Number Of Services | 10581 |
| Number Of Medicare Beneficiaries | 1410 |
| Total Submitted Charge Amount | 1530990 |
| Total Medicare Allowed Amount | 862268.77 |
| Total Medicare Payment Amount | 662523.43 |
| Total Medicare Standardized Payment Amount | 667722.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2117 |
| Number Of Medicare Beneficiaries With Drug Services | 217 |
| Total Drug Submitted ChargeAmount | 16385 |
| Total Drug Medicare AllowedAmount | 4790.68 |
| Total Drug Medicare PaymentAmount | 3755.72 |
| Total Drug Medicare Standardized Payment Amount | 3755.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 8464 |
| Number Of Medicare Beneficiaries With Medical Services | 1410 |
| Total Medical Submitted Charge Amount | 1514605 |
| Total Medical Medicare Allowed Amount | 857478.09 |
| Total Medical Medicare Payment Amount | 658767.71 |
| Total Medical Medicare Standardized Payment Amount | 663966.56 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 339 |
| Number Of Beneficiaries Age 75 to 84 | 613 |
| Number Of Beneficiaries Age Greater 84 | 401 |
| Number Of Female Beneficiaries | 681 |
| Number Of Male Beneficiaries | 729 |
| Number Of Non Hispanic White Beneficiaries | 1331 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1347 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.642 |