| National Provider Identifier [NPI]: | 1134389968 |
| Last Name Of The Provider | MASTOURI |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1801 N SENATE AVE |
| Street Address 2 Of The Provider | MPC II STE. 4000 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 46202 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 4526 |
| Number Of Medicare Beneficiaries | 2741 |
| Total Submitted Charge Amount | 446501 |
| Total Medicare Allowed Amount | 159141.15 |
| Total Medicare Payment Amount | 119224.68 |
| Total Medicare Standardized Payment Amount | 124595.51 |
| 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 | 46 |
| Number Of Medical Services | 4526 |
| Number Of Medicare Beneficiaries With Medical Services | 2741 |
| Total Medical Submitted Charge Amount | 446501 |
| Total Medical Medicare Allowed Amount | 159141.15 |
| Total Medical Medicare Payment Amount | 119224.68 |
| Total Medical Medicare Standardized Payment Amount | 124595.51 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 1045 |
| Number Of Beneficiaries Age 65 to 74 | 972 |
| Number Of Beneficiaries Age 75 to 84 | 534 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 1518 |
| Number Of Male Beneficiaries | 1223 |
| Number Of Non Hispanic White Beneficiaries | 1677 |
| Number Of Black or African American Beneficiaries | 968 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1249 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1492 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3531 |