| National Provider Identifier [NPI]: | 1508885914 |
| Last Name Of The Provider | MIKHAIL |
| First Name Of The Provider | WALID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8611 W POINT DOUGLAS RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | COTTAGE GROVE |
| Zip Code Of The Provider | 550164005 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 3492 |
| Number Of Medicare Beneficiaries | 473 |
| Total Submitted Charge Amount | 390483 |
| Total Medicare Allowed Amount | 159676.42 |
| Total Medicare Payment Amount | 115090.1 |
| Total Medicare Standardized Payment Amount | 119218.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 648 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 13554 |
| Total Drug Medicare AllowedAmount | 5794.71 |
| Total Drug Medicare PaymentAmount | 4904.78 |
| Total Drug Medicare Standardized Payment Amount | 4904.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 2844 |
| Number Of Medicare Beneficiaries With Medical Services | 473 |
| Total Medical Submitted Charge Amount | 376929 |
| Total Medical Medicare Allowed Amount | 153881.71 |
| Total Medical Medicare Payment Amount | 110185.32 |
| Total Medical Medicare Standardized Payment Amount | 114313.28 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 200 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 227 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 425 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 314 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3153 |