| National Provider Identifier [NPI]: | 1730193541 |
| Last Name Of The Provider | POURAKBAR |
| First Name Of The Provider | MOHAMMAD |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4811 S ARROWHEAD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDEPENDENCE |
| Zip Code Of The Provider | 640556981 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 3639 |
| Number Of Medicare Beneficiaries | 282 |
| Total Submitted Charge Amount | 191530 |
| Total Medicare Allowed Amount | 117632.63 |
| Total Medicare Payment Amount | 91973.15 |
| Total Medicare Standardized Payment Amount | 94640.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 518 |
| Number Of Medicare Beneficiaries With Drug Services | 193 |
| Total Drug Submitted ChargeAmount | 12399 |
| Total Drug Medicare AllowedAmount | 6409.39 |
| Total Drug Medicare PaymentAmount | 5791.33 |
| Total Drug Medicare Standardized Payment Amount | 5791.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 3121 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 179131 |
| Total Medical Medicare Allowed Amount | 111223.24 |
| Total Medical Medicare Payment Amount | 86181.82 |
| Total Medical Medicare Standardized Payment Amount | 88849.12 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 221 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0647 |