| National Provider Identifier [NPI]: | 1538340708 |
| Last Name Of The Provider | AL-MUDHAFAR |
| First Name Of The Provider | SHAYMA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 PAYNE ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FALLS CHURCH |
| Zip Code Of The Provider | 220412313 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 386 |
| Number Of Medicare Beneficiaries | 43 |
| Total Submitted Charge Amount | 72334 |
| Total Medicare Allowed Amount | 25151.3 |
| Total Medicare Payment Amount | 18007.08 |
| Total Medicare Standardized Payment Amount | 15884.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 8100 |
| Total Drug Medicare AllowedAmount | 106.21 |
| Total Drug Medicare PaymentAmount | 88.75 |
| Total Drug Medicare Standardized Payment Amount | 88.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 325 |
| Number Of Medicare Beneficiaries With Medical Services | 43 |
| Total Medical Submitted Charge Amount | 64234 |
| Total Medical Medicare Allowed Amount | 25045.09 |
| Total Medical Medicare Payment Amount | 17918.33 |
| Total Medical Medicare Standardized Payment Amount | 15795.57 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 23 |
| Number Of Male Beneficiaries | 20 |
| Number Of Non Hispanic White Beneficiaries | 22 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 15 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.206 |