| National Provider Identifier [NPI]: | 1013928282 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | TARIQ |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8421 POINTE LOOP DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 34293 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1382 |
| Number Of Medicare Beneficiaries | 745 |
| Total Submitted Charge Amount | 453575.23 |
| Total Medicare Allowed Amount | 194199 |
| Total Medicare Payment Amount | 141969.25 |
| Total Medicare Standardized Payment Amount | 143033.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1382 |
| Number Of Medicare Beneficiaries With Medical Services | 745 |
| Total Medical Submitted Charge Amount | 453575.23 |
| Total Medical Medicare Allowed Amount | 194199 |
| Total Medical Medicare Payment Amount | 141969.25 |
| Total Medical Medicare Standardized Payment Amount | 143033.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 422 |
| Number Of Male Beneficiaries | 323 |
| Number Of Non Hispanic White Beneficiaries | 723 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1285 |