| National Provider Identifier [NPI]: | 1942515531 |
| Last Name Of The Provider | SAMAR |
| First Name Of The Provider | AMENA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.B.B.S. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 19TH ST S |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352491900 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 580 |
| Number Of Medicare Beneficiaries | 294 |
| Total Submitted Charge Amount | 83838.38 |
| Total Medicare Allowed Amount | 76587.4 |
| Total Medicare Payment Amount | 56951.37 |
| Total Medicare Standardized Payment Amount | 60969.77 |
| 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 | 19 |
| Number Of Medical Services | 580 |
| Number Of Medicare Beneficiaries With Medical Services | 294 |
| Total Medical Submitted Charge Amount | 83838.38 |
| Total Medical Medicare Allowed Amount | 76587.4 |
| Total Medical Medicare Payment Amount | 56951.37 |
| Total Medical Medicare Standardized Payment Amount | 60969.77 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 240 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.3811 |