| National Provider Identifier [NPI]: | 1023018470 |
| Last Name Of The Provider | MUSTAFA |
| First Name Of The Provider | EID |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 BROOK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763015601 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 2006 |
| Number Of Medicare Beneficiaries | 546 |
| Total Submitted Charge Amount | 1356860 |
| Total Medicare Allowed Amount | 431288.62 |
| Total Medicare Payment Amount | 327557.36 |
| Total Medicare Standardized Payment Amount | 344164.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 345 |
| Total Drug Medicare AllowedAmount | 107.83 |
| Total Drug Medicare PaymentAmount | 79.88 |
| Total Drug Medicare Standardized Payment Amount | 79.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 1987 |
| Number Of Medicare Beneficiaries With Medical Services | 546 |
| Total Medical Submitted Charge Amount | 1356515 |
| Total Medical Medicare Allowed Amount | 431180.79 |
| Total Medical Medicare Payment Amount | 327477.48 |
| Total Medical Medicare Standardized Payment Amount | 344085.05 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 510 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 486 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2874 |