| National Provider Identifier [NPI]: | 1013905389 |
| Last Name Of The Provider | DESSOUKI |
| First Name Of The Provider | AMR |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3803 S BASCOM AVE |
| Street Address 2 Of The Provider | STE 104 |
| City Of The Provider | CAMPBELL |
| Zip Code Of The Provider | 950087317 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 9052 |
| Number Of Medicare Beneficiaries | 895 |
| Total Submitted Charge Amount | 4396211.18 |
| Total Medicare Allowed Amount | 1635334.85 |
| Total Medicare Payment Amount | 1247913.37 |
| Total Medicare Standardized Payment Amount | 1177335.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2056 |
| Number Of Medicare Beneficiaries With Drug Services | 251 |
| Total Drug Submitted ChargeAmount | 1504833.03 |
| Total Drug Medicare AllowedAmount | 804047.37 |
| Total Drug Medicare PaymentAmount | 626199.64 |
| Total Drug Medicare Standardized Payment Amount | 626199.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 6996 |
| Number Of Medicare Beneficiaries With Medical Services | 895 |
| Total Medical Submitted Charge Amount | 2891378.15 |
| Total Medical Medicare Allowed Amount | 831287.48 |
| Total Medical Medicare Payment Amount | 621713.73 |
| Total Medical Medicare Standardized Payment Amount | 551136.01 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 301 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 519 |
| Number Of Male Beneficiaries | 376 |
| Number Of Non Hispanic White Beneficiaries | 480 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 218 |
| Number Of Hispanic Beneficiaries | 169 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 533 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 362 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4633 |