| National Provider Identifier [NPI]: | 1902841927 |
| Last Name Of The Provider | MUMTAZ |
| First Name Of The Provider | MUHAMMAD |
| 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 | 63 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROCKTON |
| Zip Code Of The Provider | 023014012 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 781 |
| Number Of Medicare Beneficiaries | 712 |
| Total Submitted Charge Amount | 241310 |
| Total Medicare Allowed Amount | 113393.74 |
| Total Medicare Payment Amount | 88406.05 |
| Total Medicare Standardized Payment Amount | 87580.15 |
| 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 | 13 |
| Number Of Medical Services | 781 |
| Number Of Medicare Beneficiaries With Medical Services | 712 |
| Total Medical Submitted Charge Amount | 241310 |
| Total Medical Medicare Allowed Amount | 113393.74 |
| Total Medical Medicare Payment Amount | 88406.05 |
| Total Medical Medicare Standardized Payment Amount | 87580.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 162 |
| Number Of Female Beneficiaries | 384 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 603 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 293 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3503 |