| National Provider Identifier [NPI]: | 1316932270 |
| Last Name Of The Provider | MOSTAFA |
| First Name Of The Provider | ESSAM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17150 EUCLID ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | FOUNTAIN VALLEY |
| Zip Code Of The Provider | 927084092 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 4260 |
| Number Of Medicare Beneficiaries | 536 |
| Total Submitted Charge Amount | 896600 |
| Total Medicare Allowed Amount | 592014.72 |
| Total Medicare Payment Amount | 462848.36 |
| Total Medicare Standardized Payment Amount | 429543.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 4260 |
| Number Of Medicare Beneficiaries With Medical Services | 536 |
| Total Medical Submitted Charge Amount | 896600 |
| Total Medical Medicare Allowed Amount | 592014.72 |
| Total Medical Medicare Payment Amount | 462848.36 |
| Total Medical Medicare Standardized Payment Amount | 429543.42 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 287 |
| Number Of Non Hispanic White Beneficiaries | 203 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 190 |
| Number Of Hispanic Beneficiaries | 119 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 46 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 73 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 74 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 3.9858 |