| National Provider Identifier [NPI]: | 1386875011 |
| Last Name Of The Provider | FORA |
| First Name Of The Provider | AHMAD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 402 DELTA RD APT 4 |
| Street Address 2 Of The Provider | |
| City Of The Provider | AMHERST |
| Zip Code Of The Provider | 142261114 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 39023 |
| Number Of Medicare Beneficiaries | 356 |
| Total Submitted Charge Amount | 2477014.17 |
| Total Medicare Allowed Amount | 699360.1 |
| Total Medicare Payment Amount | 547312.78 |
| Total Medicare Standardized Payment Amount | 558750.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 37 |
| Number Of Drug Services | 33764 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 1861454.44 |
| Total Drug Medicare AllowedAmount | 479357.43 |
| Total Drug Medicare PaymentAmount | 375403.96 |
| Total Drug Medicare Standardized Payment Amount | 375403.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 5259 |
| Number Of Medicare Beneficiaries With Medical Services | 356 |
| Total Medical Submitted Charge Amount | 615559.73 |
| Total Medical Medicare Allowed Amount | 220002.67 |
| Total Medical Medicare Payment Amount | 171908.82 |
| Total Medical Medicare Standardized Payment Amount | 183346.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 242 |
| Number Of Black or African American Beneficiaries | |
| 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 | 264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 54 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9845 |