| National Provider Identifier [NPI]: | 1336110238 |
| Last Name Of The Provider | AL-ANSARI |
| First Name Of The Provider | MOHAMMED |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25422 GODDARD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAYLOR |
| Zip Code Of The Provider | 481806200 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 2118 |
| Number Of Medicare Beneficiaries | 753 |
| Total Submitted Charge Amount | 669845 |
| Total Medicare Allowed Amount | 303982.15 |
| Total Medicare Payment Amount | 231924.83 |
| Total Medicare Standardized Payment Amount | 224257.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 97 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 57550 |
| Total Drug Medicare AllowedAmount | 20066.45 |
| Total Drug Medicare PaymentAmount | 15031.31 |
| Total Drug Medicare Standardized Payment Amount | 15031.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2021 |
| Number Of Medicare Beneficiaries With Medical Services | 752 |
| Total Medical Submitted Charge Amount | 612295 |
| Total Medical Medicare Allowed Amount | 283915.7 |
| Total Medical Medicare Payment Amount | 216893.52 |
| Total Medical Medicare Standardized Payment Amount | 209226.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 291 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 549 |
| Number Of Non Hispanic White Beneficiaries | 601 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 229 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9566 |