| National Provider Identifier [NPI]: | 1659365484 |
| Last Name Of The Provider | GIRGIS |
| First Name Of The Provider | KAMAL |
| 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 | 2900 W 16TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 474213510 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3717 |
| Number Of Medicare Beneficiaries | 735 |
| Total Submitted Charge Amount | 293000.42 |
| Total Medicare Allowed Amount | 222229.2 |
| Total Medicare Payment Amount | 158012.57 |
| Total Medicare Standardized Payment Amount | 167709.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 979 |
| Number Of Medicare Beneficiaries With Drug Services | 264 |
| Total Drug Submitted ChargeAmount | 16486.81 |
| Total Drug Medicare AllowedAmount | 11909.29 |
| Total Drug Medicare PaymentAmount | 11278.7 |
| Total Drug Medicare Standardized Payment Amount | 11278.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 2738 |
| Number Of Medicare Beneficiaries With Medical Services | 735 |
| Total Medical Submitted Charge Amount | 276513.61 |
| Total Medical Medicare Allowed Amount | 210319.91 |
| Total Medical Medicare Payment Amount | 146733.87 |
| Total Medical Medicare Standardized Payment Amount | 156431.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 235 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 408 |
| Number Of Male Beneficiaries | 327 |
| 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 | 586 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2362 |