| National Provider Identifier [NPI]: | 1326016858 |
| Last Name Of The Provider | BOLOURCHI |
| First Name Of The Provider | HABIB |
| 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 | 18958 COASTAL HIGHWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | REHOBETH BEACH |
| Zip Code Of The Provider | 19971 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 5703 |
| Number Of Medicare Beneficiaries | 952 |
| Total Submitted Charge Amount | 542774.96 |
| Total Medicare Allowed Amount | 270709.23 |
| Total Medicare Payment Amount | 193323.11 |
| Total Medicare Standardized Payment Amount | 189814.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 276 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 14857 |
| Total Drug Medicare AllowedAmount | 9349.12 |
| Total Drug Medicare PaymentAmount | 7518.64 |
| Total Drug Medicare Standardized Payment Amount | 7518.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 5427 |
| Number Of Medicare Beneficiaries With Medical Services | 952 |
| Total Medical Submitted Charge Amount | 527917.96 |
| Total Medical Medicare Allowed Amount | 261360.11 |
| Total Medical Medicare Payment Amount | 185804.47 |
| Total Medical Medicare Standardized Payment Amount | 182295.65 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 397 |
| Number Of Beneficiaries Age 75 to 84 | 334 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 466 |
| Number Of Male Beneficiaries | 486 |
| Number Of Non Hispanic White Beneficiaries | 837 |
| Number Of Black or African American Beneficiaries | 82 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 808 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4957 |