| National Provider Identifier [NPI]: | 1285686428 |
| Last Name Of The Provider | YAQOOB |
| First Name Of The Provider | KHALID |
| 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 | 450 W STATE ROAD 434 |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | LONGWOOD |
| Zip Code Of The Provider | 327505187 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 3652 |
| Number Of Medicare Beneficiaries | 1101 |
| Total Submitted Charge Amount | 834027.27 |
| Total Medicare Allowed Amount | 367844.28 |
| Total Medicare Payment Amount | 277948.42 |
| Total Medicare Standardized Payment Amount | 280417.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 6604.24 |
| Total Drug Medicare AllowedAmount | 3212.11 |
| Total Drug Medicare PaymentAmount | 2518.28 |
| Total Drug Medicare Standardized Payment Amount | 2518.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 3586 |
| Number Of Medicare Beneficiaries With Medical Services | 1101 |
| Total Medical Submitted Charge Amount | 827423.03 |
| Total Medical Medicare Allowed Amount | 364632.17 |
| Total Medical Medicare Payment Amount | 275430.14 |
| Total Medical Medicare Standardized Payment Amount | 277899.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 349 |
| Number Of Beneficiaries Age 75 to 84 | 321 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 610 |
| Number Of Male Beneficiaries | 491 |
| Number Of Non Hispanic White Beneficiaries | 799 |
| Number Of Black or African American Beneficiaries | 156 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 116 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 803 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 298 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9454 |