| National Provider Identifier [NPI]: | 1104899269 |
| Last Name Of The Provider | GHANEM |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24211 LITTLE MACK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST CLAIR SHORES |
| Zip Code Of The Provider | 480801190 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 5979 |
| Number Of Medicare Beneficiaries | 1797 |
| Total Submitted Charge Amount | 700201 |
| Total Medicare Allowed Amount | 420245.33 |
| Total Medicare Payment Amount | 318514.04 |
| Total Medicare Standardized Payment Amount | 314219.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 694 |
| Number Of Medicare Beneficiaries With Drug Services | 152 |
| Total Drug Submitted ChargeAmount | 32450 |
| Total Drug Medicare AllowedAmount | 11192.38 |
| Total Drug Medicare PaymentAmount | 8708.67 |
| Total Drug Medicare Standardized Payment Amount | 8708.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 5285 |
| Number Of Medicare Beneficiaries With Medical Services | 1794 |
| Total Medical Submitted Charge Amount | 667751 |
| Total Medical Medicare Allowed Amount | 409052.95 |
| Total Medical Medicare Payment Amount | 309805.37 |
| Total Medical Medicare Standardized Payment Amount | 305510.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 302 |
| Number Of Beneficiaries Age 65 to 74 | 489 |
| Number Of Beneficiaries Age 75 to 84 | 538 |
| Number Of Beneficiaries Age Greater 84 | 468 |
| Number Of Female Beneficiaries | 1081 |
| Number Of Male Beneficiaries | 716 |
| Number Of Non Hispanic White Beneficiaries | 1190 |
| Number Of Black or African American Beneficiaries | 576 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 472 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.2226 |