National Provider Identifier [NPI]: |
1780799965 |
Last Name Of The Provider |
MOUANNES |
First Name Of The Provider |
WASSIM |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
404 S 13TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAUREL |
Zip Code Of The Provider |
394404345 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
9286 |
Number Of Medicare Beneficiaries |
2027 |
Total Submitted Charge Amount |
2017155.5 |
Total Medicare Allowed Amount |
606051.91 |
Total Medicare Payment Amount |
443775.98 |
Total Medicare Standardized Payment Amount |
497271.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
730 |
Number Of Medicare Beneficiaries With Drug Services |
186 |
Total Drug Submitted ChargeAmount |
67543 |
Total Drug Medicare AllowedAmount |
36173.89 |
Total Drug Medicare PaymentAmount |
27994.17 |
Total Drug Medicare Standardized Payment Amount |
27994.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
8556 |
Number Of Medicare Beneficiaries With Medical Services |
2027 |
Total Medical Submitted Charge Amount |
1949612.5 |
Total Medical Medicare Allowed Amount |
569878.02 |
Total Medical Medicare Payment Amount |
415781.81 |
Total Medical Medicare Standardized Payment Amount |
469276.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
414 |
Number Of Beneficiaries Age 65 to 74 |
739 |
Number Of Beneficiaries Age 75 to 84 |
582 |
Number Of Beneficiaries Age Greater 84 |
292 |
Number Of Female Beneficiaries |
1166 |
Number Of Male Beneficiaries |
861 |
Number Of Non Hispanic White Beneficiaries |
1468 |
Number Of Black or African American Beneficiaries |
536 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1281 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
746 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4166 |