| National Provider Identifier [NPI]: | 1629052188 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | AYAZ |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 553 E 3RD ST |
| Street Address 2 Of The Provider | PAIN MANAGEMENT OF WILLIAMSPORT |
| City Of The Provider | WILLIAMSPORT |
| Zip Code Of The Provider | 177015316 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2098 |
| Number Of Medicare Beneficiaries | 151 |
| Total Submitted Charge Amount | 303694.96 |
| Total Medicare Allowed Amount | 131705.87 |
| Total Medicare Payment Amount | 100197.14 |
| Total Medicare Standardized Payment Amount | 106434.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 534 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 16470 |
| Total Drug Medicare AllowedAmount | 1039.12 |
| Total Drug Medicare PaymentAmount | 814.77 |
| Total Drug Medicare Standardized Payment Amount | 814.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1564 |
| Number Of Medicare Beneficiaries With Medical Services | 151 |
| Total Medical Submitted Charge Amount | 287224.96 |
| Total Medical Medicare Allowed Amount | 130666.75 |
| Total Medical Medicare Payment Amount | 99382.37 |
| Total Medical Medicare Standardized Payment Amount | 105620.18 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 82 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 106 |
| 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 | 26 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2638 |