| National Provider Identifier [NPI]: | 1457456881 |
| Last Name Of The Provider | DALATI |
| First Name Of The Provider | GHASSAN |
| 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 | 1279 OLD ABBOTT MOUNTAIN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESTONSBURG |
| Zip Code Of The Provider | 416531889 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 8608 |
| Number Of Medicare Beneficiaries | 2332 |
| Total Submitted Charge Amount | 1662529.56 |
| Total Medicare Allowed Amount | 570278.92 |
| Total Medicare Payment Amount | 429728.48 |
| Total Medicare Standardized Payment Amount | 467229.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 833 |
| Number Of Medicare Beneficiaries With Drug Services | 205 |
| Total Drug Submitted ChargeAmount | 90264 |
| Total Drug Medicare AllowedAmount | 43462.32 |
| Total Drug Medicare PaymentAmount | 33933.04 |
| Total Drug Medicare Standardized Payment Amount | 33933.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 7775 |
| Number Of Medicare Beneficiaries With Medical Services | 2332 |
| Total Medical Submitted Charge Amount | 1572265.56 |
| Total Medical Medicare Allowed Amount | 526816.6 |
| Total Medical Medicare Payment Amount | 395795.44 |
| Total Medical Medicare Standardized Payment Amount | 433296.47 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 754 |
| Number Of Beneficiaries Age 65 to 74 | 838 |
| Number Of Beneficiaries Age 75 to 84 | 537 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 1182 |
| Number Of Male Beneficiaries | 1150 |
| Number Of Non Hispanic White Beneficiaries | 2314 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1047 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5612 |