| National Provider Identifier [NPI]: | 1134161904 |
| Last Name Of The Provider | ALMOUSALLI |
| First Name Of The Provider | OMAR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4600 MEMORIAL DR |
| Street Address 2 Of The Provider | W3 |
| City Of The Provider | BELLEVILLE |
| Zip Code Of The Provider | 622265366 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 7868 |
| Number Of Medicare Beneficiaries | 1310 |
| Total Submitted Charge Amount | 2235730 |
| Total Medicare Allowed Amount | 816029.27 |
| Total Medicare Payment Amount | 614621.82 |
| Total Medicare Standardized Payment Amount | 620869.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 302 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 4925 |
| Total Drug Medicare AllowedAmount | 4886.62 |
| Total Drug Medicare PaymentAmount | 3786.52 |
| Total Drug Medicare Standardized Payment Amount | 3786.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 7566 |
| Number Of Medicare Beneficiaries With Medical Services | 1310 |
| Total Medical Submitted Charge Amount | 2230805 |
| Total Medical Medicare Allowed Amount | 811142.65 |
| Total Medical Medicare Payment Amount | 610835.3 |
| Total Medical Medicare Standardized Payment Amount | 617082.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 249 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 376 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 759 |
| Number Of Male Beneficiaries | 551 |
| Number Of Non Hispanic White Beneficiaries | 819 |
| Number Of Black or African American Beneficiaries | 455 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 904 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 406 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8281 |