| National Provider Identifier [NPI]: | 1326077058 |
| Last Name Of The Provider | MANSOUR |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1315 E UNION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENVILLE |
| Zip Code Of The Provider | 387033245 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 6093 |
| Number Of Medicare Beneficiaries | 1394 |
| Total Submitted Charge Amount | 1428089.59 |
| Total Medicare Allowed Amount | 426577.92 |
| Total Medicare Payment Amount | 309194.53 |
| Total Medicare Standardized Payment Amount | 340599.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 72 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1890.24 |
| Total Drug Medicare AllowedAmount | 59.39 |
| Total Drug Medicare PaymentAmount | 46.51 |
| Total Drug Medicare Standardized Payment Amount | 46.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 6021 |
| Number Of Medicare Beneficiaries With Medical Services | 1394 |
| Total Medical Submitted Charge Amount | 1426199.35 |
| Total Medical Medicare Allowed Amount | 426518.53 |
| Total Medical Medicare Payment Amount | 309148.02 |
| Total Medical Medicare Standardized Payment Amount | 340553.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 217 |
| Number Of Beneficiaries Age 65 to 74 | 494 |
| Number Of Beneficiaries Age 75 to 84 | 451 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 776 |
| Number Of Male Beneficiaries | 618 |
| Number Of Non Hispanic White Beneficiaries | 781 |
| Number Of Black or African American Beneficiaries | 597 |
| 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 | 869 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 525 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.633 |