| National Provider Identifier [NPI]: | 1821012113 |
| Last Name Of The Provider | KHALIL |
| First Name Of The Provider | TAHER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M D P A |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1425 HAND AVE |
| Street Address 2 Of The Provider | SUITE K |
| City Of The Provider | ORMOND BEACH |
| Zip Code Of The Provider | 321741135 |
| 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 | 67 |
| Number Of Services | 9108 |
| Number Of Medicare Beneficiaries | 1214 |
| Total Submitted Charge Amount | 827209.77 |
| Total Medicare Allowed Amount | 494334.2 |
| Total Medicare Payment Amount | 375034.94 |
| Total Medicare Standardized Payment Amount | 384235.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4607 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 39903.44 |
| Total Drug Medicare AllowedAmount | 15365.44 |
| Total Drug Medicare PaymentAmount | 11855.27 |
| Total Drug Medicare Standardized Payment Amount | 11855.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 4501 |
| Number Of Medicare Beneficiaries With Medical Services | 1214 |
| Total Medical Submitted Charge Amount | 787306.33 |
| Total Medical Medicare Allowed Amount | 478968.76 |
| Total Medical Medicare Payment Amount | 363179.67 |
| Total Medical Medicare Standardized Payment Amount | 372380.42 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 436 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 234 |
| Number Of Female Beneficiaries | 624 |
| Number Of Male Beneficiaries | 590 |
| Number Of Non Hispanic White Beneficiaries | 1078 |
| Number Of Black or African American Beneficiaries | 97 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 956 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 258 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9292 |