| National Provider Identifier [NPI]: | 1861566119 |
| Last Name Of The Provider | HALABY |
| First Name Of The Provider | ISSAM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D.,PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 436 NOKOMIS AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342852617 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 263 |
| Number Of Services | 4346 |
| Number Of Medicare Beneficiaries | 1328 |
| Total Submitted Charge Amount | 1410027.6 |
| Total Medicare Allowed Amount | 642479.8 |
| Total Medicare Payment Amount | 496737.57 |
| Total Medicare Standardized Payment Amount | 485533.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 263 |
| Number Of Medical Services | 4346 |
| Number Of Medicare Beneficiaries With Medical Services | 1328 |
| Total Medical Submitted Charge Amount | 1410027.6 |
| Total Medical Medicare Allowed Amount | 642479.8 |
| Total Medical Medicare Payment Amount | 496737.57 |
| Total Medical Medicare Standardized Payment Amount | 485533.61 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 439 |
| Number Of Beneficiaries Age 75 to 84 | 485 |
| Number Of Beneficiaries Age Greater 84 | 344 |
| Number Of Female Beneficiaries | 645 |
| Number Of Male Beneficiaries | 683 |
| Number Of Non Hispanic White Beneficiaries | 1296 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7839 |