| National Provider Identifier [NPI]: | 1538195664 |
| Last Name Of The Provider | DABBOUS |
| First Name Of The Provider | SAMIR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22060 BEECH ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | DEARBORN |
| Zip Code Of The Provider | 481242847 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 24642 |
| Number Of Medicare Beneficiaries | 8301 |
| Total Submitted Charge Amount | 2657484.95 |
| Total Medicare Allowed Amount | 666962.36 |
| Total Medicare Payment Amount | 508154.06 |
| Total Medicare Standardized Payment Amount | 493308.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 102 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 5850.95 |
| Total Drug Medicare AllowedAmount | 4339.3 |
| Total Drug Medicare PaymentAmount | 3402.05 |
| Total Drug Medicare Standardized Payment Amount | 3402.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 24540 |
| Number Of Medicare Beneficiaries With Medical Services | 8301 |
| Total Medical Submitted Charge Amount | 2651634 |
| Total Medical Medicare Allowed Amount | 662623.06 |
| Total Medical Medicare Payment Amount | 504752.01 |
| Total Medical Medicare Standardized Payment Amount | 489906.51 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1780 |
| Number Of Beneficiaries Age 65 to 74 | 2611 |
| Number Of Beneficiaries Age 75 to 84 | 2309 |
| Number Of Beneficiaries Age Greater 84 | 1601 |
| Number Of Female Beneficiaries | 4518 |
| Number Of Male Beneficiaries | 3783 |
| Number Of Non Hispanic White Beneficiaries | 6065 |
| Number Of Black or African American Beneficiaries | 1497 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 359 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 232 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2665 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1537 |