| National Provider Identifier [NPI]: | 1801880471 |
| Last Name Of The Provider | DOUMET |
| First Name Of The Provider | MAHDI |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6855 SPRING VALLEY DR |
| Street Address 2 Of The Provider | #120 |
| City Of The Provider | HOLLAND |
| Zip Code Of The Provider | 435288039 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1941 |
| Number Of Medicare Beneficiaries | 396 |
| Total Submitted Charge Amount | 283442.12 |
| Total Medicare Allowed Amount | 183420.74 |
| Total Medicare Payment Amount | 142274.79 |
| Total Medicare Standardized Payment Amount | 145015.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 352.48 |
| Total Drug Medicare AllowedAmount | 209.65 |
| Total Drug Medicare PaymentAmount | 203.22 |
| Total Drug Medicare Standardized Payment Amount | 203.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1927 |
| Number Of Medicare Beneficiaries With Medical Services | 396 |
| Total Medical Submitted Charge Amount | 283089.64 |
| Total Medical Medicare Allowed Amount | 183211.09 |
| Total Medical Medicare Payment Amount | 142071.57 |
| Total Medical Medicare Standardized Payment Amount | 144812.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 128 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 322 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9067 |