| National Provider Identifier [NPI]: | 1598783862 |
| Last Name Of The Provider | KHOURY |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1516 COTNER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900253303 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 21588 |
| Number Of Medicare Beneficiaries | 1596 |
| Total Submitted Charge Amount | 2059863.37 |
| Total Medicare Allowed Amount | 704829.63 |
| Total Medicare Payment Amount | 549436.75 |
| Total Medicare Standardized Payment Amount | 536148.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 18832 |
| Number Of Medicare Beneficiaries With Drug Services | 269 |
| Total Drug Submitted ChargeAmount | 41847.5 |
| Total Drug Medicare AllowedAmount | 6444.07 |
| Total Drug Medicare PaymentAmount | 4720.39 |
| Total Drug Medicare Standardized Payment Amount | 4720.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 2756 |
| Number Of Medicare Beneficiaries With Medical Services | 1596 |
| Total Medical Submitted Charge Amount | 2018015.87 |
| Total Medical Medicare Allowed Amount | 698385.56 |
| Total Medical Medicare Payment Amount | 544716.36 |
| Total Medical Medicare Standardized Payment Amount | 531427.98 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 359 |
| Number Of Beneficiaries Age 65 to 74 | 687 |
| Number Of Beneficiaries Age 75 to 84 | 390 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 1006 |
| Number Of Male Beneficiaries | 590 |
| Number Of Non Hispanic White Beneficiaries | 746 |
| Number Of Black or African American Beneficiaries | 197 |
| Number Of AsianPacific Islander Beneficiaries | 274 |
| Number Of Hispanic Beneficiaries | 344 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 804 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 792 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4636 |