| National Provider Identifier [NPI]: | 1770788036 |
| Last Name Of The Provider | MORTADA |
| First Name Of The Provider | MOHAMMAD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2801 W KINNICKINNIC RIVER PKWY |
| Street Address 2 Of The Provider | SUITE 777 |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532153669 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 7223 |
| Number Of Medicare Beneficiaries | 2231 |
| Total Submitted Charge Amount | 2504069 |
| Total Medicare Allowed Amount | 371334.25 |
| Total Medicare Payment Amount | 279883.88 |
| Total Medicare Standardized Payment Amount | 297024.9 |
| 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 | 90 |
| Number Of Medical Services | 7223 |
| Number Of Medicare Beneficiaries With Medical Services | 2231 |
| Total Medical Submitted Charge Amount | 2504069 |
| Total Medical Medicare Allowed Amount | 371334.25 |
| Total Medical Medicare Payment Amount | 279883.88 |
| Total Medical Medicare Standardized Payment Amount | 297024.9 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 348 |
| Number Of Beneficiaries Age 65 to 74 | 733 |
| Number Of Beneficiaries Age 75 to 84 | 724 |
| Number Of Beneficiaries Age Greater 84 | 426 |
| Number Of Female Beneficiaries | 1117 |
| Number Of Male Beneficiaries | 1114 |
| Number Of Non Hispanic White Beneficiaries | 1802 |
| Number Of Black or African American Beneficiaries | 266 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 591 |
| Percent Of With Atrial Fibrillation | 42 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3037 |