| National Provider Identifier [NPI]: | 1013999291 |
| Last Name Of The Provider | GOREISH |
| First Name Of The Provider | HISHAM |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 GILBREATH DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ONEONTA |
| Zip Code Of The Provider | 351212827 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 775 |
| Number Of Medicare Beneficiaries | 659 |
| Total Submitted Charge Amount | 446081.02 |
| Total Medicare Allowed Amount | 100681.73 |
| Total Medicare Payment Amount | 76538.41 |
| Total Medicare Standardized Payment Amount | 78291.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 775 |
| Number Of Medicare Beneficiaries With Medical Services | 659 |
| Total Medical Submitted Charge Amount | 446081.02 |
| Total Medical Medicare Allowed Amount | 100681.73 |
| Total Medical Medicare Payment Amount | 76538.41 |
| Total Medical Medicare Standardized Payment Amount | 78291.68 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 183 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 375 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 417 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 267 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9046 |