| National Provider Identifier [NPI]: | 1245276351 |
| Last Name Of The Provider | KHOURY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 MILLWOOD ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | CARO |
| Zip Code Of The Provider | 487231656 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 3965 |
| Number Of Medicare Beneficiaries | 943 |
| Total Submitted Charge Amount | 497942 |
| Total Medicare Allowed Amount | 380711.5 |
| Total Medicare Payment Amount | 286835.93 |
| Total Medicare Standardized Payment Amount | 300780.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 166 |
| Total Drug Medicare AllowedAmount | 21.98 |
| Total Drug Medicare PaymentAmount | 17.16 |
| Total Drug Medicare Standardized Payment Amount | 17.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 3926 |
| Number Of Medicare Beneficiaries With Medical Services | 942 |
| Total Medical Submitted Charge Amount | 497776 |
| Total Medical Medicare Allowed Amount | 380689.52 |
| Total Medical Medicare Payment Amount | 286818.77 |
| Total Medical Medicare Standardized Payment Amount | 300763.19 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 276 |
| Number Of Beneficiaries Age Greater 84 | 242 |
| Number Of Female Beneficiaries | 572 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 907 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 617 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 326 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5335 |