| National Provider Identifier [NPI]: | 1720077589 |
| Last Name Of The Provider | MANSOUR |
| First Name Of The Provider | NAWAR |
| 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 | 1325 EASTMORELAND AVE |
| Street Address 2 Of The Provider | SUITE 335 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381043519 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 4127.5 |
| Number Of Medicare Beneficiaries | 1038 |
| Total Submitted Charge Amount | 2461330 |
| Total Medicare Allowed Amount | 726104.09 |
| Total Medicare Payment Amount | 547015.46 |
| Total Medicare Standardized Payment Amount | 580539.75 |
| 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 | 4127.5 |
| Number Of Medicare Beneficiaries With Medical Services | 1038 |
| Total Medical Submitted Charge Amount | 2461330 |
| Total Medical Medicare Allowed Amount | 726104.09 |
| Total Medical Medicare Payment Amount | 547015.46 |
| Total Medical Medicare Standardized Payment Amount | 580539.75 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 296 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 277 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 572 |
| Number Of Male Beneficiaries | 466 |
| Number Of Non Hispanic White Beneficiaries | 349 |
| Number Of Black or African American Beneficiaries | 673 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 692 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 346 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 3.5818 |