| National Provider Identifier [NPI]: | 1669582417 |
| Last Name Of The Provider | JABR |
| First Name Of The Provider | AYMAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2222 W DIVISION |
| Street Address 2 Of The Provider | ST MARY AND ELIZABETH MEDICAL CENTER SUITE 2100 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 60622 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 10729 |
| Number Of Medicare Beneficiaries | 543 |
| Total Submitted Charge Amount | 1164160 |
| Total Medicare Allowed Amount | 445754.07 |
| Total Medicare Payment Amount | 335382.85 |
| Total Medicare Standardized Payment Amount | 295899.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 5465 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 120160 |
| Total Drug Medicare AllowedAmount | 6808.39 |
| Total Drug Medicare PaymentAmount | 5609.81 |
| Total Drug Medicare Standardized Payment Amount | 5609.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 5264 |
| Number Of Medicare Beneficiaries With Medical Services | 543 |
| Total Medical Submitted Charge Amount | 1044000 |
| Total Medical Medicare Allowed Amount | 438945.68 |
| Total Medical Medicare Payment Amount | 329773.04 |
| Total Medical Medicare Standardized Payment Amount | 290289.92 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 318 |
| Number Of Non Hispanic White Beneficiaries | 80 |
| Number Of Black or African American Beneficiaries | 231 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 220 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 84 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 459 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 40 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 36 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9611 |