| National Provider Identifier [NPI]: | 1679525216 |
| Last Name Of The Provider | HATEM |
| First Name Of The Provider | GHALEB |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4655 S TELEGRAPH RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEARBORN HEIGHTS |
| Zip Code Of The Provider | 481251936 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 9866 |
| Number Of Medicare Beneficiaries | 1059 |
| Total Submitted Charge Amount | 2340695 |
| Total Medicare Allowed Amount | 1441617.23 |
| Total Medicare Payment Amount | 1093047.43 |
| Total Medicare Standardized Payment Amount | 1059769.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 522 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 325240 |
| Total Drug Medicare AllowedAmount | 287031.65 |
| Total Drug Medicare PaymentAmount | 223951.86 |
| Total Drug Medicare Standardized Payment Amount | 223951.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 9344 |
| Number Of Medicare Beneficiaries With Medical Services | 1059 |
| Total Medical Submitted Charge Amount | 2015455 |
| Total Medical Medicare Allowed Amount | 1154585.58 |
| Total Medical Medicare Payment Amount | 869095.57 |
| Total Medical Medicare Standardized Payment Amount | 835817.75 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 341 |
| Number Of Beneficiaries Age 75 to 84 | 359 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 602 |
| Number Of Male Beneficiaries | 457 |
| Number Of Non Hispanic White Beneficiaries | 846 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 795 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 264 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7309 |