| National Provider Identifier [NPI]: | 1215904255 |
| Last Name Of The Provider | MEMON |
| First Name Of The Provider | MUMTAZ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5325 ELLIOTT DR |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | YPSILANTI |
| Zip Code Of The Provider | 481978633 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 4476 |
| Number Of Medicare Beneficiaries | 1875 |
| Total Submitted Charge Amount | 705139 |
| Total Medicare Allowed Amount | 213736.84 |
| Total Medicare Payment Amount | 160645.2 |
| Total Medicare Standardized Payment Amount | 164196.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 4476 |
| Number Of Medicare Beneficiaries With Medical Services | 1875 |
| Total Medical Submitted Charge Amount | 705139 |
| Total Medical Medicare Allowed Amount | 213736.84 |
| Total Medical Medicare Payment Amount | 160645.2 |
| Total Medical Medicare Standardized Payment Amount | 164196.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 321 |
| Number Of Beneficiaries Age 65 to 74 | 628 |
| Number Of Beneficiaries Age 75 to 84 | 604 |
| Number Of Beneficiaries Age Greater 84 | 322 |
| Number Of Female Beneficiaries | 992 |
| Number Of Male Beneficiaries | 883 |
| Number Of Non Hispanic White Beneficiaries | 1714 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1473 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 402 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6965 |