| National Provider Identifier [NPI]: | 1376541078 |
| Last Name Of The Provider | KABBANI |
| First Name Of The Provider | AZMI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 MARTIN LUTHER KING JR BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312013206 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 7517 |
| Number Of Medicare Beneficiaries | 614 |
| Total Submitted Charge Amount | 1088662.83 |
| Total Medicare Allowed Amount | 374875.5 |
| Total Medicare Payment Amount | 297157.02 |
| Total Medicare Standardized Payment Amount | 308104.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1090 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 43600 |
| Total Drug Medicare AllowedAmount | 12495.98 |
| Total Drug Medicare PaymentAmount | 9796.91 |
| Total Drug Medicare Standardized Payment Amount | 9796.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 6427 |
| Number Of Medicare Beneficiaries With Medical Services | 614 |
| Total Medical Submitted Charge Amount | 1045062.83 |
| Total Medical Medicare Allowed Amount | 362379.52 |
| Total Medical Medicare Payment Amount | 287360.11 |
| Total Medical Medicare Standardized Payment Amount | 298307.17 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 198 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 298 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 387 |
| Number Of Black or African American Beneficiaries | 214 |
| 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 | 483 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 3.5375 |