| National Provider Identifier [NPI]: | 1053517540 |
| Last Name Of The Provider | SOUEIDAN |
| First Name Of The Provider | ALI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 S TRUMBULL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAY CITY |
| Zip Code Of The Provider | 487087656 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 3310 |
| Number Of Medicare Beneficiaries | 803 |
| Total Submitted Charge Amount | 696277 |
| Total Medicare Allowed Amount | 392208.65 |
| Total Medicare Payment Amount | 306237.21 |
| Total Medicare Standardized Payment Amount | 314992.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 125 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 5288 |
| Total Drug Medicare AllowedAmount | 4402.41 |
| Total Drug Medicare PaymentAmount | 4314.22 |
| Total Drug Medicare Standardized Payment Amount | 4314.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 3185 |
| Number Of Medicare Beneficiaries With Medical Services | 803 |
| Total Medical Submitted Charge Amount | 690989 |
| Total Medical Medicare Allowed Amount | 387806.24 |
| Total Medical Medicare Payment Amount | 301922.99 |
| Total Medical Medicare Standardized Payment Amount | 310678.23 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 160 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 264 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 404 |
| Number Of Male Beneficiaries | 399 |
| Number Of Non Hispanic White Beneficiaries | 774 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 566 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 237 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1501 |