| National Provider Identifier [NPI]: | 1124093414 |
| Last Name Of The Provider | HUSSAIN |
| First Name Of The Provider | AHMER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 N BROADWAY ST |
| Street Address 2 Of The Provider | BOX 787 |
| City Of The Provider | POTEAU |
| Zip Code Of The Provider | 749532609 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 1041 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 133988.91 |
| Total Medicare Allowed Amount | 73581.49 |
| Total Medicare Payment Amount | 50641.76 |
| Total Medicare Standardized Payment Amount | 55439.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1450 |
| Total Drug Medicare AllowedAmount | 176.96 |
| Total Drug Medicare PaymentAmount | 149.18 |
| Total Drug Medicare Standardized Payment Amount | 149.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 973 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 132538.91 |
| Total Medical Medicare Allowed Amount | 73404.53 |
| Total Medical Medicare Payment Amount | 50492.58 |
| Total Medical Medicare Standardized Payment Amount | 55290.52 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 188 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3427 |