| National Provider Identifier [NPI]: | 1376625913 |
| Last Name Of The Provider | BAILONY |
| First Name Of The Provider | MOHAMMED |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 EUCLID AVE STE 205 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NATIONAL CITY |
| Zip Code Of The Provider | 919502967 |
| 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 | 14 |
| Number Of Services | 240 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 27400 |
| Total Medicare Allowed Amount | 19016.5 |
| Total Medicare Payment Amount | 14814.12 |
| Total Medicare Standardized Payment Amount | 14319.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 840 |
| Total Drug Medicare AllowedAmount | 357.28 |
| Total Drug Medicare PaymentAmount | 350.14 |
| Total Drug Medicare Standardized Payment Amount | 350.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 212 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 26560 |
| Total Medical Medicare Allowed Amount | 18659.22 |
| Total Medical Medicare Payment Amount | 14463.98 |
| Total Medical Medicare Standardized Payment Amount | 13969.66 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 37 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 21 |
| Number Of Black or African American Beneficiaries | 37 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 18 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.9356 |