| National Provider Identifier [NPI]: | 1588653257 |
| Last Name Of The Provider | KHATIB |
| First Name Of The Provider | YAZAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7011 A C SKINNER PKWY |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322566954 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 37897 |
| Number Of Medicare Beneficiaries | 958 |
| Total Submitted Charge Amount | 5492088.5 |
| Total Medicare Allowed Amount | 2182278.09 |
| Total Medicare Payment Amount | 1695914.2 |
| Total Medicare Standardized Payment Amount | 1752447.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 24 |
| Number Of Drug Services | 32999 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 54005.5 |
| Total Drug Medicare AllowedAmount | 14718.15 |
| Total Drug Medicare PaymentAmount | 11476.03 |
| Total Drug Medicare Standardized Payment Amount | 11476.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 141 |
| Number Of Medical Services | 4898 |
| Number Of Medicare Beneficiaries With Medical Services | 958 |
| Total Medical Submitted Charge Amount | 5438083 |
| Total Medical Medicare Allowed Amount | 2167559.94 |
| Total Medical Medicare Payment Amount | 1684438.17 |
| Total Medical Medicare Standardized Payment Amount | 1740971.9 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 160 |
| Number Of Beneficiaries Age 65 to 74 | 416 |
| Number Of Beneficiaries Age 75 to 84 | 269 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 506 |
| Number Of Male Beneficiaries | 452 |
| Number Of Non Hispanic White Beneficiaries | 707 |
| Number Of Black or African American Beneficiaries | 181 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 723 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1902 |