| National Provider Identifier [NPI]: | 1497701072 |
| Last Name Of The Provider | MIRZA |
| First Name Of The Provider | ATIQUE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19 WOODLAND ST |
| Street Address 2 Of The Provider | SUITE# 35 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061052372 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 3060 |
| Number Of Medicare Beneficiaries | 894 |
| Total Submitted Charge Amount | 633880.17 |
| Total Medicare Allowed Amount | 267016.65 |
| Total Medicare Payment Amount | 202712.33 |
| Total Medicare Standardized Payment Amount | 190740.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 184 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 10281 |
| Total Drug Medicare AllowedAmount | 9742.5 |
| Total Drug Medicare PaymentAmount | 7464.94 |
| Total Drug Medicare Standardized Payment Amount | 7464.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2876 |
| Number Of Medicare Beneficiaries With Medical Services | 894 |
| Total Medical Submitted Charge Amount | 623599.17 |
| Total Medical Medicare Allowed Amount | 257274.15 |
| Total Medical Medicare Payment Amount | 195247.39 |
| Total Medical Medicare Standardized Payment Amount | 183275.07 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 301 |
| Number Of Beneficiaries Age Greater 84 | 248 |
| Number Of Female Beneficiaries | 490 |
| Number Of Male Beneficiaries | 404 |
| Number Of Non Hispanic White Beneficiaries | 720 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 600 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 294 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9626 |