| National Provider Identifier [NPI]: | 1417915521 |
| Last Name Of The Provider | FAHEID |
| First Name Of The Provider | EHAB |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 78TH ST |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | NORTH BERGEN |
| Zip Code Of The Provider | 070474927 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1930 |
| Number Of Medicare Beneficiaries | 829 |
| Total Submitted Charge Amount | 861880 |
| Total Medicare Allowed Amount | 206568.4 |
| Total Medicare Payment Amount | 161449.2 |
| Total Medicare Standardized Payment Amount | 167241.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1930 |
| Number Of Medicare Beneficiaries With Medical Services | 829 |
| Total Medical Submitted Charge Amount | 861880 |
| Total Medical Medicare Allowed Amount | 206568.4 |
| Total Medical Medicare Payment Amount | 161449.2 |
| Total Medical Medicare Standardized Payment Amount | 167241.82 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 174 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 253 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 467 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 728 |
| Number Of Black or African American Beneficiaries | 71 |
| 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 | 557 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 272 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.8179 |