| National Provider Identifier [NPI]: | 1972682219 |
| Last Name Of The Provider | GHAZAL |
| First Name Of The Provider | HASSAN |
| 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 | 200 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE 3-O |
| City Of The Provider | HAZARD |
| Zip Code Of The Provider | 417019466 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 101992 |
| Number Of Medicare Beneficiaries | 597 |
| Total Submitted Charge Amount | 4721155.7 |
| Total Medicare Allowed Amount | 2110430.97 |
| Total Medicare Payment Amount | 1661132.02 |
| Total Medicare Standardized Payment Amount | 1670436.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 52 |
| Number Of Drug Services | 81767 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 3545020.7 |
| Total Drug Medicare AllowedAmount | 1548846.45 |
| Total Drug Medicare PaymentAmount | 1205864.27 |
| Total Drug Medicare Standardized Payment Amount | 1205864.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 20225 |
| Number Of Medicare Beneficiaries With Medical Services | 597 |
| Total Medical Submitted Charge Amount | 1176135 |
| Total Medical Medicare Allowed Amount | 561584.52 |
| Total Medical Medicare Payment Amount | 455267.75 |
| Total Medical Medicare Standardized Payment Amount | 464572.64 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 180 |
| Number Of Beneficiaries Age 65 to 74 | 227 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 257 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 281 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 40 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.1563 |