| National Provider Identifier [NPI]: | 1558391227 |
| Last Name Of The Provider | MIKHAIL |
| First Name Of The Provider | DIAA |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1005 N POINT BLVD |
| Street Address 2 Of The Provider | SUITE 708 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212243415 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 2582 |
| Number Of Medicare Beneficiaries | 464 |
| Total Submitted Charge Amount | 344295 |
| Total Medicare Allowed Amount | 218115.44 |
| Total Medicare Payment Amount | 148284.23 |
| Total Medicare Standardized Payment Amount | 140998.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 258 |
| Number Of Medicare Beneficiaries With Drug Services | 216 |
| Total Drug Submitted ChargeAmount | 7920 |
| Total Drug Medicare AllowedAmount | 3596.85 |
| Total Drug Medicare PaymentAmount | 3495.35 |
| Total Drug Medicare Standardized Payment Amount | 3495.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2324 |
| Number Of Medicare Beneficiaries With Medical Services | 464 |
| Total Medical Submitted Charge Amount | 336375 |
| Total Medical Medicare Allowed Amount | 214518.59 |
| Total Medical Medicare Payment Amount | 144788.88 |
| Total Medical Medicare Standardized Payment Amount | 137503.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 426 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 388 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1161 |