| National Provider Identifier [NPI]: | 1336119742 |
| Last Name Of The Provider | MASTOOR |
| First Name Of The Provider | MOMINA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 EAST 33RD STREET |
| Street Address 2 Of The Provider | SUITE 551 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 21218 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 3500 |
| Number Of Medicare Beneficiaries | 1411 |
| Total Submitted Charge Amount | 446600 |
| Total Medicare Allowed Amount | 215410.9 |
| Total Medicare Payment Amount | 163860.11 |
| Total Medicare Standardized Payment Amount | 155737.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 7245 |
| Total Drug Medicare AllowedAmount | 3658.09 |
| Total Drug Medicare PaymentAmount | 2752.7 |
| Total Drug Medicare Standardized Payment Amount | 2752.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3431 |
| Number Of Medicare Beneficiaries With Medical Services | 1411 |
| Total Medical Submitted Charge Amount | 439355 |
| Total Medical Medicare Allowed Amount | 211752.81 |
| Total Medical Medicare Payment Amount | 161107.41 |
| Total Medical Medicare Standardized Payment Amount | 152985.05 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 331 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 196 |
| Number Of Female Beneficiaries | 812 |
| Number Of Male Beneficiaries | 599 |
| Number Of Non Hispanic White Beneficiaries | 599 |
| Number Of Black or African American Beneficiaries | 787 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 918 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 493 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2782 |