| National Provider Identifier [NPI]: | 1164694477 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | SHAHNAZ |
| 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 | 3348 E FM 528 RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRIENDSWOOD |
| Zip Code Of The Provider | 775465012 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 502 |
| Number Of Medicare Beneficiaries | 63 |
| Total Submitted Charge Amount | 58752 |
| Total Medicare Allowed Amount | 33270.31 |
| Total Medicare Payment Amount | 23890.11 |
| Total Medicare Standardized Payment Amount | 23886.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 99 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 2429 |
| Total Drug Medicare AllowedAmount | 335.99 |
| Total Drug Medicare PaymentAmount | 281.73 |
| Total Drug Medicare Standardized Payment Amount | 281.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 403 |
| Number Of Medicare Beneficiaries With Medical Services | 63 |
| Total Medical Submitted Charge Amount | 56323 |
| Total Medical Medicare Allowed Amount | 32934.32 |
| Total Medical Medicare Payment Amount | 23608.38 |
| Total Medical Medicare Standardized Payment Amount | 23604.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | 52 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1964 |