| National Provider Identifier [NPI]: | 1386600310 |
| Last Name Of The Provider | KHATIB |
| First Name Of The Provider | ABD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 659 W HAMILTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAU CLAIRE |
| Zip Code Of The Provider | 547016925 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 5364 |
| Number Of Medicare Beneficiaries | 777 |
| Total Submitted Charge Amount | 484938.58 |
| Total Medicare Allowed Amount | 349140.81 |
| Total Medicare Payment Amount | 264309.57 |
| Total Medicare Standardized Payment Amount | 279852.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 115 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 2975 |
| Total Drug Medicare AllowedAmount | 1771 |
| Total Drug Medicare PaymentAmount | 1735.35 |
| Total Drug Medicare Standardized Payment Amount | 1735.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 5249 |
| Number Of Medicare Beneficiaries With Medical Services | 777 |
| Total Medical Submitted Charge Amount | 481963.58 |
| Total Medical Medicare Allowed Amount | 347369.81 |
| Total Medical Medicare Payment Amount | 262574.22 |
| Total Medical Medicare Standardized Payment Amount | 278116.92 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 273 |
| Number Of Beneficiaries Age 75 to 84 | 270 |
| Number Of Beneficiaries Age Greater 84 | 175 |
| Number Of Female Beneficiaries | 402 |
| Number Of Male Beneficiaries | 375 |
| Number Of Non Hispanic White Beneficiaries | 758 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5267 |