| National Provider Identifier [NPI]: | 1679684807 |
| Last Name Of The Provider | HOSSAIN |
| First Name Of The Provider | MOHAMMAD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 627 BROOKSIDE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | REDLANDS |
| Zip Code Of The Provider | 923734666 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 672 |
| Number Of Medicare Beneficiaries | 114 |
| Total Submitted Charge Amount | 90490 |
| Total Medicare Allowed Amount | 60344.31 |
| Total Medicare Payment Amount | 42190.86 |
| Total Medicare Standardized Payment Amount | 40562.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1005 |
| Total Drug Medicare AllowedAmount | 263.15 |
| Total Drug Medicare PaymentAmount | 252.63 |
| Total Drug Medicare Standardized Payment Amount | 252.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 639 |
| Number Of Medicare Beneficiaries With Medical Services | 114 |
| Total Medical Submitted Charge Amount | 89485 |
| Total Medical Medicare Allowed Amount | 60081.16 |
| Total Medical Medicare Payment Amount | 41938.23 |
| Total Medical Medicare Standardized Payment Amount | 40310.06 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 60 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 32 |
| Number Of Black or African American Beneficiaries | 43 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2125 |