| National Provider Identifier [NPI]: | 1740338417 |
| Last Name Of The Provider | KHAJA |
| First Name Of The Provider | IBRAHIM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2535 BETHANY RD |
| Street Address 2 Of The Provider | SUITE 201B |
| City Of The Provider | SYCAMORE |
| Zip Code Of The Provider | 601783126 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 1232 |
| Number Of Medicare Beneficiaries | 285 |
| Total Submitted Charge Amount | 122248 |
| Total Medicare Allowed Amount | 67487.25 |
| Total Medicare Payment Amount | 45388.67 |
| Total Medicare Standardized Payment Amount | 42931.34 |
| 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 | 10 |
| Number Of Medical Services | 1232 |
| Number Of Medicare Beneficiaries With Medical Services | 285 |
| Total Medical Submitted Charge Amount | 122248 |
| Total Medical Medicare Allowed Amount | 67487.25 |
| Total Medical Medicare Payment Amount | 45388.67 |
| Total Medical Medicare Standardized Payment Amount | 42931.34 |
| Average Age Of Beneficiaries | 50 |
| Number Of Beneficiaries Age Less65 | 251 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 213 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 55 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 230 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 69 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 48 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1219 |