| National Provider Identifier [NPI]: | 1104082809 |
| Last Name Of The Provider | FARHAT |
| First Name Of The Provider | MOHAMED |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1205 S MAIN ST |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | CROWN POINT |
| Zip Code Of The Provider | 463073676 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 454205 |
| Number Of Medicare Beneficiaries | 815 |
| Total Submitted Charge Amount | 17434161 |
| Total Medicare Allowed Amount | 6824194.9 |
| Total Medicare Payment Amount | 5300372.09 |
| Total Medicare Standardized Payment Amount | 5311546.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 75 |
| Number Of Drug Services | 443596 |
| Number Of Medicare Beneficiaries With Drug Services | 250 |
| Total Drug Submitted ChargeAmount | 15350517 |
| Total Drug Medicare AllowedAmount | 6044974.63 |
| Total Drug Medicare PaymentAmount | 4701299.45 |
| Total Drug Medicare Standardized Payment Amount | 4701299.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 10609 |
| Number Of Medicare Beneficiaries With Medical Services | 815 |
| Total Medical Submitted Charge Amount | 2083644 |
| Total Medical Medicare Allowed Amount | 779220.27 |
| Total Medical Medicare Payment Amount | 599072.64 |
| Total Medical Medicare Standardized Payment Amount | 610246.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 353 |
| Number Of Beneficiaries Age 75 to 84 | 279 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 477 |
| Number Of Male Beneficiaries | 338 |
| Number Of Non Hispanic White Beneficiaries | 775 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8196 |