| National Provider Identifier [NPI]: | 1871555052 |
| Last Name Of The Provider | MOOSA |
| First Name Of The Provider | ABDUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 WEST FAIRMONT PARKWAY |
| Street Address 2 Of The Provider | SUITE # D |
| City Of The Provider | LA PORTE |
| Zip Code Of The Provider | 775716305 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1411 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 146733.8 |
| Total Medicare Allowed Amount | 97950.86 |
| Total Medicare Payment Amount | 65771.29 |
| Total Medicare Standardized Payment Amount | 66405.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 55 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 2640 |
| Total Drug Medicare AllowedAmount | 713.32 |
| Total Drug Medicare PaymentAmount | 676.82 |
| Total Drug Medicare Standardized Payment Amount | 676.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1356 |
| Number Of Medicare Beneficiaries With Medical Services | 266 |
| Total Medical Submitted Charge Amount | 144093.8 |
| Total Medical Medicare Allowed Amount | 97237.54 |
| Total Medical Medicare Payment Amount | 65094.47 |
| Total Medical Medicare Standardized Payment Amount | 65728.69 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 145 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | 202 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2793 |