| National Provider Identifier [NPI]: | 1285628313 |
| Last Name Of The Provider | KHOURI |
| First Name Of The Provider | SAMER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 ARLINGTON AVE |
| Street Address 2 Of The Provider | MEDICINE |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436142595 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4206 |
| Number Of Medicare Beneficiaries | 1988 |
| Total Submitted Charge Amount | 680332 |
| Total Medicare Allowed Amount | 278423.77 |
| Total Medicare Payment Amount | 210045.69 |
| Total Medicare Standardized Payment Amount | 219381.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 9576 |
| Total Drug Medicare AllowedAmount | 4019.9 |
| Total Drug Medicare PaymentAmount | 3151.55 |
| Total Drug Medicare Standardized Payment Amount | 3151.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 4130 |
| Number Of Medicare Beneficiaries With Medical Services | 1987 |
| Total Medical Submitted Charge Amount | 670756 |
| Total Medical Medicare Allowed Amount | 274403.87 |
| Total Medical Medicare Payment Amount | 206894.14 |
| Total Medical Medicare Standardized Payment Amount | 216230.1 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 514 |
| Number Of Beneficiaries Age 65 to 74 | 691 |
| Number Of Beneficiaries Age 75 to 84 | 513 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 1052 |
| Number Of Male Beneficiaries | 936 |
| Number Of Non Hispanic White Beneficiaries | 1514 |
| Number Of Black or African American Beneficiaries | 355 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1268 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 720 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2913 |