| National Provider Identifier [NPI]: | 1982606448 |
| Last Name Of The Provider | MANDVIWALA |
| First Name Of The Provider | MUSTAFA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13406 MEDICAL COMPLEX DR |
| Street Address 2 Of The Provider | STE 110 |
| City Of The Provider | TOMBALL |
| Zip Code Of The Provider | 773753332 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 5298 |
| Number Of Medicare Beneficiaries | 819 |
| Total Submitted Charge Amount | 1835414.57 |
| Total Medicare Allowed Amount | 607958.53 |
| Total Medicare Payment Amount | 454061.23 |
| Total Medicare Standardized Payment Amount | 460004.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 364 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 54600 |
| Total Drug Medicare AllowedAmount | 19273.78 |
| Total Drug Medicare PaymentAmount | 14785.07 |
| Total Drug Medicare Standardized Payment Amount | 14785.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 4934 |
| Number Of Medicare Beneficiaries With Medical Services | 819 |
| Total Medical Submitted Charge Amount | 1780814.57 |
| Total Medical Medicare Allowed Amount | 588684.75 |
| Total Medical Medicare Payment Amount | 439276.16 |
| Total Medical Medicare Standardized Payment Amount | 445219.09 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 304 |
| Number Of Beneficiaries Age 75 to 84 | 264 |
| Number Of Beneficiaries Age Greater 84 | 181 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 708 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 704 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.8636 |