| National Provider Identifier [NPI]: | 1366725749 |
| Last Name Of The Provider | EISA |
| First Name Of The Provider | EMAD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 280 FOREST PARK CIRCLE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PANAMA CITY |
| Zip Code Of The Provider | 324054919 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3441 |
| Number Of Medicare Beneficiaries | 818 |
| Total Submitted Charge Amount | 662448.68 |
| Total Medicare Allowed Amount | 321939.71 |
| Total Medicare Payment Amount | 252154.36 |
| Total Medicare Standardized Payment Amount | 251082.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 717 |
| Total Drug Medicare AllowedAmount | 300.98 |
| Total Drug Medicare PaymentAmount | 287.29 |
| Total Drug Medicare Standardized Payment Amount | 287.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 3362 |
| Number Of Medicare Beneficiaries With Medical Services | 818 |
| Total Medical Submitted Charge Amount | 661731.68 |
| Total Medical Medicare Allowed Amount | 321638.73 |
| Total Medical Medicare Payment Amount | 251867.07 |
| Total Medical Medicare Standardized Payment Amount | 250795.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 187 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 152 |
| Number Of Female Beneficiaries | 449 |
| Number Of Male Beneficiaries | 369 |
| Number Of Non Hispanic White Beneficiaries | 742 |
| Number Of Black or African American Beneficiaries | 60 |
| 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 | 515 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 303 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.8396 |