| National Provider Identifier [NPI]: | 1679671127 |
| Last Name Of The Provider | DABAGHI |
| First Name Of The Provider | SALIM |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 146 E HOSPITAL DR |
| Street Address 2 Of The Provider | STE. 201 |
| City Of The Provider | ANGLETON |
| Zip Code Of The Provider | 775154169 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 13586.8 |
| Number Of Medicare Beneficiaries | 1964 |
| Total Submitted Charge Amount | 2088486.46 |
| Total Medicare Allowed Amount | 1027565.98 |
| Total Medicare Payment Amount | 775037.43 |
| Total Medicare Standardized Payment Amount | 778286.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 939.8 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 56405.42 |
| Total Drug Medicare AllowedAmount | 37505.84 |
| Total Drug Medicare PaymentAmount | 28904.85 |
| Total Drug Medicare Standardized Payment Amount | 28904.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 12647 |
| Number Of Medicare Beneficiaries With Medical Services | 1963 |
| Total Medical Submitted Charge Amount | 2032081.04 |
| Total Medical Medicare Allowed Amount | 990060.14 |
| Total Medical Medicare Payment Amount | 746132.58 |
| Total Medical Medicare Standardized Payment Amount | 749382.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 802 |
| Number Of Beneficiaries Age 75 to 84 | 630 |
| Number Of Beneficiaries Age Greater 84 | 297 |
| Number Of Female Beneficiaries | 1113 |
| Number Of Male Beneficiaries | 851 |
| Number Of Non Hispanic White Beneficiaries | 1589 |
| Number Of Black or African American Beneficiaries | 174 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 184 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1613 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 351 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3639 |