| National Provider Identifier [NPI]: | 1083663744 |
| Last Name Of The Provider | GHOBRIAL |
| First Name Of The Provider | MICHEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 124 MAIN ST |
| Street Address 2 Of The Provider | SUITE 12 |
| City Of The Provider | HUNTINGTON |
| Zip Code Of The Provider | 117436922 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 4900 |
| Number Of Medicare Beneficiaries | 376 |
| Total Submitted Charge Amount | 591420 |
| Total Medicare Allowed Amount | 390782.23 |
| Total Medicare Payment Amount | 301896.57 |
| Total Medicare Standardized Payment Amount | 261854.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 5425 |
| Total Drug Medicare AllowedAmount | 3676.23 |
| Total Drug Medicare PaymentAmount | 3585.1 |
| Total Drug Medicare Standardized Payment Amount | 3585.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 4741 |
| Number Of Medicare Beneficiaries With Medical Services | 376 |
| Total Medical Submitted Charge Amount | 585995 |
| Total Medical Medicare Allowed Amount | 387106 |
| Total Medical Medicare Payment Amount | 298311.47 |
| Total Medical Medicare Standardized Payment Amount | 258269.86 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 180 |
| Number Of Non Hispanic White Beneficiaries | 347 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 356 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2393 |