| National Provider Identifier [NPI]: | 1699719138 |
| Last Name Of The Provider | GHANDOUR |
| First Name Of The Provider | ELIAS |
| 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 | 3814 22ND PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794101118 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 4201 |
| Number Of Medicare Beneficiaries | 1217 |
| Total Submitted Charge Amount | 1229393.05 |
| Total Medicare Allowed Amount | 452858.91 |
| Total Medicare Payment Amount | 338509.38 |
| Total Medicare Standardized Payment Amount | 342135.54 |
| 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 | 63 |
| Number Of Medical Services | 4201 |
| Number Of Medicare Beneficiaries With Medical Services | 1217 |
| Total Medical Submitted Charge Amount | 1229393.05 |
| Total Medical Medicare Allowed Amount | 452858.91 |
| Total Medical Medicare Payment Amount | 338509.38 |
| Total Medical Medicare Standardized Payment Amount | 342135.54 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 496 |
| Number Of Beneficiaries Age 75 to 84 | 444 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 661 |
| Number Of Male Beneficiaries | 556 |
| Number Of Non Hispanic White Beneficiaries | 917 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 239 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1021 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7024 |