| National Provider Identifier [NPI]: | 1255308599 |
| Last Name Of The Provider | MOURSI |
| First Name Of The Provider | HOUSAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 AVENUE F NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINTER HAVEN |
| Zip Code Of The Provider | 338814131 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Osteopathic Manipulative Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 1655 |
| Number Of Medicare Beneficiaries | 1048 |
| Total Submitted Charge Amount | 1170085 |
| Total Medicare Allowed Amount | 172374.27 |
| Total Medicare Payment Amount | 124749.64 |
| Total Medicare Standardized Payment Amount | 123801.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 1725 |
| Total Drug Medicare AllowedAmount | 138.7 |
| Total Drug Medicare PaymentAmount | 60.8 |
| Total Drug Medicare Standardized Payment Amount | 60.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1559 |
| Number Of Medicare Beneficiaries With Medical Services | 1047 |
| Total Medical Submitted Charge Amount | 1168360 |
| Total Medical Medicare Allowed Amount | 172235.57 |
| Total Medical Medicare Payment Amount | 124688.84 |
| Total Medical Medicare Standardized Payment Amount | 123740.6 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 318 |
| Number Of Beneficiaries Age 65 to 74 | 371 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 635 |
| Number Of Male Beneficiaries | 413 |
| Number Of Non Hispanic White Beneficiaries | 752 |
| Number Of Black or African American Beneficiaries | 137 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 124 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 346 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7275 |