| National Provider Identifier [NPI]: | 1124079173 |
| Last Name Of The Provider | KHALILI |
| First Name Of The Provider | SHAHRIAR |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 285 SILLS ROAD |
| Street Address 2 Of The Provider | BUILDING #14 |
| City Of The Provider | EAST PATCHOGUE |
| Zip Code Of The Provider | 117724869 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 5374 |
| Number Of Medicare Beneficiaries | 1476 |
| Total Submitted Charge Amount | 1140687.83 |
| Total Medicare Allowed Amount | 472879.12 |
| Total Medicare Payment Amount | 353543.06 |
| Total Medicare Standardized Payment Amount | 312751.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 354 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 28091.32 |
| Total Drug Medicare AllowedAmount | 18034.4 |
| Total Drug Medicare PaymentAmount | 14012.39 |
| Total Drug Medicare Standardized Payment Amount | 14012.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 5020 |
| Number Of Medicare Beneficiaries With Medical Services | 1476 |
| Total Medical Submitted Charge Amount | 1112596.51 |
| Total Medical Medicare Allowed Amount | 454844.72 |
| Total Medical Medicare Payment Amount | 339530.67 |
| Total Medical Medicare Standardized Payment Amount | 298739.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 530 |
| Number Of Beneficiaries Age 75 to 84 | 436 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 810 |
| Number Of Male Beneficiaries | 666 |
| Number Of Non Hispanic White Beneficiaries | 1250 |
| Number Of Black or African American Beneficiaries | 100 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1043 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 433 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9506 |