| National Provider Identifier [NPI]: | 1639158827 |
| Last Name Of The Provider | TRABOULSSI |
| First Name Of The Provider | MOURHAF |
| 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 | 703 TYLER ST |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | SANDUSKY |
| Zip Code Of The Provider | 448703367 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 5332 |
| Number Of Medicare Beneficiaries | 2334 |
| Total Submitted Charge Amount | 747987 |
| Total Medicare Allowed Amount | 354283.24 |
| Total Medicare Payment Amount | 259426.06 |
| Total Medicare Standardized Payment Amount | 268188.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 5332 |
| Number Of Medicare Beneficiaries With Medical Services | 2334 |
| Total Medical Submitted Charge Amount | 747987 |
| Total Medical Medicare Allowed Amount | 354283.24 |
| Total Medical Medicare Payment Amount | 259426.06 |
| Total Medical Medicare Standardized Payment Amount | 268188.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 325 |
| Number Of Beneficiaries Age 65 to 74 | 814 |
| Number Of Beneficiaries Age 75 to 84 | 809 |
| Number Of Beneficiaries Age Greater 84 | 386 |
| Number Of Female Beneficiaries | 1160 |
| Number Of Male Beneficiaries | 1174 |
| Number Of Non Hispanic White Beneficiaries | 2131 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1894 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 440 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7418 |