| National Provider Identifier [NPI]: | 1912218686 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | MOEID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 490 BLUE HILLS AVE |
| Street Address 2 Of The Provider | SAINT FRANCIS MECICAL GROUP, INC |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061121513 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 371 |
| Number Of Medicare Beneficiaries | 170 |
| Total Submitted Charge Amount | 64435 |
| Total Medicare Allowed Amount | 32902.63 |
| Total Medicare Payment Amount | 25511.79 |
| Total Medicare Standardized Payment Amount | 24336.84 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 94 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| 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 | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 59 |
| Average HCC Risk Score Of Beneficiaries | 1.5333 |