| National Provider Identifier [NPI]: | 1548375827 |
| Last Name Of The Provider | FAHOUM |
| First Name Of The Provider | SAMER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD FCCP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 VAUGHAN MEMORIAL DRIVE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | SELMA |
| Zip Code Of The Provider | 36701 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 3429 |
| Number Of Medicare Beneficiaries | 584 |
| Total Submitted Charge Amount | 709229.68 |
| Total Medicare Allowed Amount | 377221.07 |
| Total Medicare Payment Amount | 288526.61 |
| Total Medicare Standardized Payment Amount | 309729.13 |
| 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 | 39 |
| Number Of Medical Services | 3429 |
| Number Of Medicare Beneficiaries With Medical Services | 584 |
| Total Medical Submitted Charge Amount | 709229.68 |
| Total Medical Medicare Allowed Amount | 377221.07 |
| Total Medical Medicare Payment Amount | 288526.61 |
| Total Medical Medicare Standardized Payment Amount | 309729.13 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 367 |
| 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 | 256 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 328 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 28 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 75 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 72 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.5424 |