| National Provider Identifier [NPI]: | 1083624134 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | ISMATH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9315 TELEGRAPH |
| Street Address 2 Of The Provider | |
| City Of The Provider | REDFORD |
| Zip Code Of The Provider | 48239 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 865 |
| Number Of Medicare Beneficiaries | 168 |
| Total Submitted Charge Amount | 52065.7 |
| Total Medicare Allowed Amount | 44982.85 |
| Total Medicare Payment Amount | 32513.68 |
| Total Medicare Standardized Payment Amount | 32286 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 279 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 3090.7 |
| Total Drug Medicare AllowedAmount | 3087.48 |
| Total Drug Medicare PaymentAmount | 2374.25 |
| Total Drug Medicare Standardized Payment Amount | 2374.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 586 |
| Number Of Medicare Beneficiaries With Medical Services | 167 |
| Total Medical Submitted Charge Amount | 48975 |
| Total Medical Medicare Allowed Amount | 41895.37 |
| Total Medical Medicare Payment Amount | 30139.43 |
| Total Medical Medicare Standardized Payment Amount | 29911.75 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 96 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | 104 |
| 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 | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 122 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 60 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 52 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2946 |