| National Provider Identifier [NPI]: | 1740227453 |
| Last Name Of The Provider | MOSTOUFI |
| First Name Of The Provider | EBRAHIM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3702 WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 303 |
| City Of The Provider | HOLLYWOOD |
| Zip Code Of The Provider | 330218282 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 15130 |
| Number Of Medicare Beneficiaries | 955 |
| Total Submitted Charge Amount | 2037035.68 |
| Total Medicare Allowed Amount | 632725.09 |
| Total Medicare Payment Amount | 490692.28 |
| Total Medicare Standardized Payment Amount | 484573.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12379 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 50965.5 |
| Total Drug Medicare AllowedAmount | 36478.31 |
| Total Drug Medicare PaymentAmount | 28605.98 |
| Total Drug Medicare Standardized Payment Amount | 28605.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2751 |
| Number Of Medicare Beneficiaries With Medical Services | 955 |
| Total Medical Submitted Charge Amount | 1986070.18 |
| Total Medical Medicare Allowed Amount | 596246.78 |
| Total Medical Medicare Payment Amount | 462086.3 |
| Total Medical Medicare Standardized Payment Amount | 455967.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 340 |
| Number Of Beneficiaries Age 75 to 84 | 273 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 423 |
| Number Of Non Hispanic White Beneficiaries | 566 |
| Number Of Black or African American Beneficiaries | 164 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 178 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 575 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 380 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.217 |