| National Provider Identifier [NPI]: | 1508174376 |
| Last Name Of The Provider | BRAIK |
| First Name Of The Provider | TAREQ |
| 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 | 407 W COUNTRY CLUB RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROSWELL |
| Zip Code Of The Provider | 882015209 |
| State Code Of The Provider | NM |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 61752 |
| Number Of Medicare Beneficiaries | 530 |
| Total Submitted Charge Amount | 2023405.7 |
| Total Medicare Allowed Amount | 1872261.5 |
| Total Medicare Payment Amount | 1463950.77 |
| Total Medicare Standardized Payment Amount | 1472815.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 62 |
| Number Of Drug Services | 53336 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 1498646.23 |
| Total Drug Medicare AllowedAmount | 1450387.57 |
| Total Drug Medicare PaymentAmount | 1135816.99 |
| Total Drug Medicare Standardized Payment Amount | 1135816.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 8416 |
| Number Of Medicare Beneficiaries With Medical Services | 530 |
| Total Medical Submitted Charge Amount | 524759.47 |
| Total Medical Medicare Allowed Amount | 421873.93 |
| Total Medical Medicare Payment Amount | 328133.78 |
| Total Medical Medicare Standardized Payment Amount | 336998.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 207 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 294 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 382 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 133 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 382 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 45 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.7894 |