| National Provider Identifier [NPI]: | 1861412223 |
| Last Name Of The Provider | SALIBA |
| First Name Of The Provider | BASSAM |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3106 NW ARLINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAWTON |
| Zip Code Of The Provider | 735056123 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 6193 |
| Number Of Medicare Beneficiaries | 1590 |
| Total Submitted Charge Amount | 1425670.08 |
| Total Medicare Allowed Amount | 429583.47 |
| Total Medicare Payment Amount | 311748.17 |
| Total Medicare Standardized Payment Amount | 334871.01 |
| 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 | 101 |
| Number Of Medical Services | 6193 |
| Number Of Medicare Beneficiaries With Medical Services | 1590 |
| Total Medical Submitted Charge Amount | 1425670.08 |
| Total Medical Medicare Allowed Amount | 429583.47 |
| Total Medical Medicare Payment Amount | 311748.17 |
| Total Medical Medicare Standardized Payment Amount | 334871.01 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 640 |
| Number Of Beneficiaries Age 75 to 84 | 579 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 818 |
| Number Of Male Beneficiaries | 772 |
| Number Of Non Hispanic White Beneficiaries | 1212 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | 142 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7063 |