| National Provider Identifier [NPI]: | 1659374320 |
| Last Name Of The Provider | KASRAEIAN |
| First Name Of The Provider | AHMAD |
| 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 | 6269 BEACH BLVD |
| Street Address 2 Of The Provider | STE 2 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322162705 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 7168 |
| Number Of Medicare Beneficiaries | 1223 |
| Total Submitted Charge Amount | 1056380.38 |
| Total Medicare Allowed Amount | 488851.87 |
| Total Medicare Payment Amount | 365005.47 |
| Total Medicare Standardized Payment Amount | 369578.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 542 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 78326.88 |
| Total Drug Medicare AllowedAmount | 24422.71 |
| Total Drug Medicare PaymentAmount | 19091.79 |
| Total Drug Medicare Standardized Payment Amount | 19091.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 6626 |
| Number Of Medicare Beneficiaries With Medical Services | 1223 |
| Total Medical Submitted Charge Amount | 978053.5 |
| Total Medical Medicare Allowed Amount | 464429.16 |
| Total Medical Medicare Payment Amount | 345913.68 |
| Total Medical Medicare Standardized Payment Amount | 350486.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 551 |
| Number Of Beneficiaries Age 75 to 84 | 408 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 907 |
| Number Of Non Hispanic White Beneficiaries | 933 |
| Number Of Black or African American Beneficiaries | 186 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1074 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3931 |