| National Provider Identifier [NPI]: | 1386636868 |
| Last Name Of The Provider | KHOUKAZ |
| First Name Of The Provider | SOUHEIL |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12855 N 40 DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631418657 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 6783 |
| Number Of Medicare Beneficiaries | 1641 |
| Total Submitted Charge Amount | 1738144 |
| Total Medicare Allowed Amount | 743764.71 |
| Total Medicare Payment Amount | 562998.87 |
| Total Medicare Standardized Payment Amount | 577889.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 656 |
| Number Of Medicare Beneficiaries With Drug Services | 162 |
| Total Drug Submitted ChargeAmount | 73763 |
| Total Drug Medicare AllowedAmount | 33925.63 |
| Total Drug Medicare PaymentAmount | 26218.98 |
| Total Drug Medicare Standardized Payment Amount | 26218.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 6127 |
| Number Of Medicare Beneficiaries With Medical Services | 1641 |
| Total Medical Submitted Charge Amount | 1664381 |
| Total Medical Medicare Allowed Amount | 709839.08 |
| Total Medical Medicare Payment Amount | 536779.89 |
| Total Medical Medicare Standardized Payment Amount | 551670.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 364 |
| Number Of Beneficiaries Age 65 to 74 | 530 |
| Number Of Beneficiaries Age 75 to 84 | 517 |
| Number Of Beneficiaries Age Greater 84 | 230 |
| Number Of Female Beneficiaries | 836 |
| Number Of Male Beneficiaries | 805 |
| Number Of Non Hispanic White Beneficiaries | 1616 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 1200 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 441 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8129 |