| National Provider Identifier [NPI]: | 1063455475 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | NIVA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 525 ALEXANDRIA PIKE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | SOUTHGATE |
| Zip Code Of The Provider | 410713290 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 4383 |
| Number Of Medicare Beneficiaries | 1629 |
| Total Submitted Charge Amount | 248890 |
| Total Medicare Allowed Amount | 148870.05 |
| Total Medicare Payment Amount | 109264.73 |
| Total Medicare Standardized Payment Amount | 116950.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 178 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 7724 |
| Total Drug Medicare AllowedAmount | 5127.74 |
| Total Drug Medicare PaymentAmount | 4941.21 |
| Total Drug Medicare Standardized Payment Amount | 4941.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 4205 |
| Number Of Medicare Beneficiaries With Medical Services | 1629 |
| Total Medical Submitted Charge Amount | 241166 |
| Total Medical Medicare Allowed Amount | 143742.31 |
| Total Medical Medicare Payment Amount | 104323.52 |
| Total Medical Medicare Standardized Payment Amount | 112009.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 383 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 426 |
| Number Of Beneficiaries Age Greater 84 | 318 |
| Number Of Female Beneficiaries | 1013 |
| Number Of Male Beneficiaries | 616 |
| Number Of Non Hispanic White Beneficiaries | 1578 |
| Number Of Black or African American Beneficiaries | 34 |
| 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 | 1135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 494 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8237 |