| National Provider Identifier [NPI]: | 1588659817 |
| Last Name Of The Provider | YACOUB |
| First Name Of The Provider | HAYAN |
| 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 | 1501 S MADISON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | APPLETON |
| Zip Code Of The Provider | 549151846 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 833 |
| Number Of Medicare Beneficiaries | 312 |
| Total Submitted Charge Amount | 106169 |
| Total Medicare Allowed Amount | 44614.15 |
| Total Medicare Payment Amount | 28162.86 |
| Total Medicare Standardized Payment Amount | 29668.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1164 |
| Total Drug Medicare AllowedAmount | 657.84 |
| Total Drug Medicare PaymentAmount | 613.79 |
| Total Drug Medicare Standardized Payment Amount | 613.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 800 |
| Number Of Medicare Beneficiaries With Medical Services | 312 |
| Total Medical Submitted Charge Amount | 105005 |
| Total Medical Medicare Allowed Amount | 43956.31 |
| Total Medical Medicare Payment Amount | 27549.07 |
| Total Medical Medicare Standardized Payment Amount | 29054.5 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 274 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1928 |