| National Provider Identifier [NPI]: | 1376592071 |
| Last Name Of The Provider | KHAWAJA |
| First Name Of The Provider | AZIMUDDIN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13640 N PLAZA DEL RIO BLVD |
| Street Address 2 Of The Provider | STE 230 |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 853814846 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 7321 |
| Number Of Medicare Beneficiaries | 1815 |
| Total Submitted Charge Amount | 1563613.2 |
| Total Medicare Allowed Amount | 733999.53 |
| Total Medicare Payment Amount | 563465.65 |
| Total Medicare Standardized Payment Amount | 568442.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 710 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 73036.2 |
| Total Drug Medicare AllowedAmount | 37590.36 |
| Total Drug Medicare PaymentAmount | 29470.61 |
| Total Drug Medicare Standardized Payment Amount | 29470.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 6611 |
| Number Of Medicare Beneficiaries With Medical Services | 1815 |
| Total Medical Submitted Charge Amount | 1490577 |
| Total Medical Medicare Allowed Amount | 696409.17 |
| Total Medical Medicare Payment Amount | 533995.04 |
| Total Medical Medicare Standardized Payment Amount | 538971.73 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 527 |
| Number Of Beneficiaries Age 75 to 84 | 702 |
| Number Of Beneficiaries Age Greater 84 | 539 |
| Number Of Female Beneficiaries | 950 |
| Number Of Male Beneficiaries | 865 |
| Number Of Non Hispanic White Beneficiaries | 1742 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1768 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4182 |