| National Provider Identifier [NPI]: | 1073588695 |
| Last Name Of The Provider | MAMUYA |
| First Name Of The Provider | KOMSU |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1260 SILAS DEANE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WETHERSFIELD |
| Zip Code Of The Provider | 061094362 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 4978 |
| Number Of Medicare Beneficiaries | 1833 |
| Total Submitted Charge Amount | 897215 |
| Total Medicare Allowed Amount | 368690.8 |
| Total Medicare Payment Amount | 279157.65 |
| Total Medicare Standardized Payment Amount | 260668.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 14185 |
| Total Drug Medicare AllowedAmount | 9970.1 |
| Total Drug Medicare PaymentAmount | 7690.85 |
| Total Drug Medicare Standardized Payment Amount | 7690.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 4745 |
| Number Of Medicare Beneficiaries With Medical Services | 1833 |
| Total Medical Submitted Charge Amount | 883030 |
| Total Medical Medicare Allowed Amount | 358720.7 |
| Total Medical Medicare Payment Amount | 271466.8 |
| Total Medical Medicare Standardized Payment Amount | 252977.18 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 558 |
| Number Of Beneficiaries Age 75 to 84 | 606 |
| Number Of Beneficiaries Age Greater 84 | 475 |
| Number Of Female Beneficiaries | 952 |
| Number Of Male Beneficiaries | 881 |
| Number Of Non Hispanic White Beneficiaries | 1486 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 155 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 589 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0378 |