| National Provider Identifier [NPI]: | 1366530131 |
| Last Name Of The Provider | BOUTROS |
| First Name Of The Provider | AYMAN |
| 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 | 21475 RIDGETOP CIR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | STERLING |
| Zip Code Of The Provider | 201666580 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 11321 |
| Number Of Medicare Beneficiaries | 1365 |
| Total Submitted Charge Amount | 1571955 |
| Total Medicare Allowed Amount | 877650.79 |
| Total Medicare Payment Amount | 657901.99 |
| Total Medicare Standardized Payment Amount | 637110.36 |
| 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 | 26 |
| Number Of Medical Services | 11321 |
| Number Of Medicare Beneficiaries With Medical Services | 1365 |
| Total Medical Submitted Charge Amount | 1571955 |
| Total Medical Medicare Allowed Amount | 877650.79 |
| Total Medical Medicare Payment Amount | 657901.99 |
| Total Medical Medicare Standardized Payment Amount | 637110.36 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 617 |
| Number Of Beneficiaries Age 75 to 84 | 519 |
| Number Of Beneficiaries Age Greater 84 | 196 |
| Number Of Female Beneficiaries | 846 |
| Number Of Male Beneficiaries | 519 |
| Number Of Non Hispanic White Beneficiaries | 1033 |
| Number Of Black or African American Beneficiaries | 136 |
| Number Of AsianPacific Islander Beneficiaries | 106 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1155 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 210 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9494 |