| National Provider Identifier [NPI]: | 1487841847 |
| Last Name Of The Provider | MECHLEB |
| First Name Of The Provider | WISSAM |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 415 S 28TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394017246 |
| 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 | 59 |
| Number Of Services | 3856 |
| Number Of Medicare Beneficiaries | 2102 |
| Total Submitted Charge Amount | 1078982 |
| Total Medicare Allowed Amount | 328017.06 |
| Total Medicare Payment Amount | 246671.78 |
| Total Medicare Standardized Payment Amount | 270747.49 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Total Drug Medicare PaymentAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 464 |
| Number Of Beneficiaries Age 65 to 74 | 743 |
| Number Of Beneficiaries Age 75 to 84 | 624 |
| Number Of Beneficiaries Age Greater 84 | 271 |
| Number Of Female Beneficiaries | 1246 |
| Number Of Male Beneficiaries | 856 |
| Number Of Non Hispanic White Beneficiaries | 1675 |
| Number Of Black or African American Beneficiaries | 399 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1322 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 780 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5643 |