| National Provider Identifier [NPI]: | 1639201395 |
| Last Name Of The Provider | MEHBOOB |
| First Name Of The Provider | ASMA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | N.P.-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12080 PEARL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTHGATE |
| Zip Code Of The Provider | 481951882 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 296 |
| Number Of Medicare Beneficiaries | 257 |
| Total Submitted Charge Amount | 190398 |
| Total Medicare Allowed Amount | 27397.27 |
| Total Medicare Payment Amount | 20523.02 |
| Total Medicare Standardized Payment Amount | 23231.16 |
| 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 | 17 |
| Number Of Medical Services | 296 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 190398 |
| Total Medical Medicare Allowed Amount | 27397.27 |
| Total Medical Medicare Payment Amount | 20523.02 |
| Total Medical Medicare Standardized Payment Amount | 23231.16 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 108 |
| Number Of Non Hispanic White Beneficiaries | 207 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 150 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5864 |