| National Provider Identifier [NPI]: | 1942229810 |
| Last Name Of The Provider | KHAN |
| First Name Of The Provider | NAEEM |
| 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 | 1050 MARTIN LUTHER KING DRIVE |
| Street Address 2 Of The Provider | STE #108 |
| City Of The Provider | CENTRALIA |
| Zip Code Of The Provider | 62801 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 9860 |
| Number Of Medicare Beneficiaries | 1264 |
| Total Submitted Charge Amount | 7605827.78 |
| Total Medicare Allowed Amount | 749556.66 |
| Total Medicare Payment Amount | 563108.4 |
| Total Medicare Standardized Payment Amount | 597417.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1317 |
| Number Of Medicare Beneficiaries With Drug Services | 310 |
| Total Drug Submitted ChargeAmount | 752450 |
| Total Drug Medicare AllowedAmount | 68467.36 |
| Total Drug Medicare PaymentAmount | 53660.84 |
| Total Drug Medicare Standardized Payment Amount | 53660.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 8543 |
| Number Of Medicare Beneficiaries With Medical Services | 1264 |
| Total Medical Submitted Charge Amount | 6853377.78 |
| Total Medical Medicare Allowed Amount | 681089.3 |
| Total Medical Medicare Payment Amount | 509447.56 |
| Total Medical Medicare Standardized Payment Amount | 543756.29 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 244 |
| Number Of Beneficiaries Age 65 to 74 | 418 |
| Number Of Beneficiaries Age 75 to 84 | 383 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 685 |
| Number Of Male Beneficiaries | 579 |
| Number Of Non Hispanic White Beneficiaries | 1194 |
| Number Of Black or African American Beneficiaries | 55 |
| 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 | 824 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 440 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8053 |