| National Provider Identifier [NPI]: | 1457361271 |
| Last Name Of The Provider | ALKOURAINY |
| First Name Of The Provider | KOUSAY |
| 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 | 480 4TH AVE |
| Street Address 2 Of The Provider | SUITE 409 |
| City Of The Provider | CHULA VISTA |
| Zip Code Of The Provider | 919104410 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 230292 |
| Number Of Medicare Beneficiaries | 392 |
| Total Submitted Charge Amount | 2598174.11 |
| Total Medicare Allowed Amount | 1411364.32 |
| Total Medicare Payment Amount | 1097487.47 |
| Total Medicare Standardized Payment Amount | 1081754.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 43 |
| Number Of Drug Services | 225346 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 2262004.76 |
| Total Drug Medicare AllowedAmount | 1190118.07 |
| Total Drug Medicare PaymentAmount | 932148.25 |
| Total Drug Medicare Standardized Payment Amount | 932148.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 4946 |
| Number Of Medicare Beneficiaries With Medical Services | 392 |
| Total Medical Submitted Charge Amount | 336169.35 |
| Total Medical Medicare Allowed Amount | 221246.25 |
| Total Medical Medicare Payment Amount | 165339.22 |
| Total Medical Medicare Standardized Payment Amount | 149606.22 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 289 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 141 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 183 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 200 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 60 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9755 |