| National Provider Identifier [NPI]: | 1689786410 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | HASAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6170 JOLIET RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COUNTRYSIDE |
| Zip Code Of The Provider | 605253956 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 2937 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 204595.97 |
| Total Medicare Allowed Amount | 188511.59 |
| Total Medicare Payment Amount | 144355.03 |
| Total Medicare Standardized Payment Amount | 135031.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 109 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 2021.97 |
| Total Drug Medicare AllowedAmount | 980.02 |
| Total Drug Medicare PaymentAmount | 923.49 |
| Total Drug Medicare Standardized Payment Amount | 923.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 2828 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 202574 |
| Total Medical Medicare Allowed Amount | 187531.57 |
| Total Medical Medicare Payment Amount | 143431.54 |
| Total Medical Medicare Standardized Payment Amount | 134107.74 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 120 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 182 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 30 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3999 |