| National Provider Identifier [NPI]: | 1396724399 |
| Last Name Of The Provider | ELTAWIL |
| First Name Of The Provider | KHALID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3701 SKYPARK DR |
| Street Address 2 Of The Provider | #200 |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905054749 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2715 |
| Number Of Medicare Beneficiaries | 662 |
| Total Submitted Charge Amount | 948653.34 |
| Total Medicare Allowed Amount | 240398.56 |
| Total Medicare Payment Amount | 183806.31 |
| Total Medicare Standardized Payment Amount | 174366.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 372 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 34816.15 |
| Total Drug Medicare AllowedAmount | 9404.16 |
| Total Drug Medicare PaymentAmount | 7336.13 |
| Total Drug Medicare Standardized Payment Amount | 7336.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 2343 |
| Number Of Medicare Beneficiaries With Medical Services | 662 |
| Total Medical Submitted Charge Amount | 913837.19 |
| Total Medical Medicare Allowed Amount | 230994.4 |
| Total Medical Medicare Payment Amount | 176470.18 |
| Total Medical Medicare Standardized Payment Amount | 167030.18 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 334 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 457 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 77 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 558 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0853 |