| National Provider Identifier [NPI]: | 1205016060 |
| Last Name Of The Provider | MAATOUK |
| First Name Of The Provider | JAMAL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4485 W STONE DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | KINGSPORT |
| Zip Code Of The Provider | 376601050 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 11087 |
| Number Of Medicare Beneficiaries | 290 |
| Total Submitted Charge Amount | 876016 |
| Total Medicare Allowed Amount | 262390.09 |
| Total Medicare Payment Amount | 199535.39 |
| Total Medicare Standardized Payment Amount | 204561.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 38 |
| Number Of Drug Services | 10089 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 630024 |
| Total Drug Medicare AllowedAmount | 180993.07 |
| Total Drug Medicare PaymentAmount | 141141.37 |
| Total Drug Medicare Standardized Payment Amount | 141141.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 998 |
| Number Of Medicare Beneficiaries With Medical Services | 290 |
| Total Medical Submitted Charge Amount | 245992 |
| Total Medical Medicare Allowed Amount | 81397.02 |
| Total Medical Medicare Payment Amount | 58394.02 |
| Total Medical Medicare Standardized Payment Amount | 63420.56 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 37 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.8756 |