| National Provider Identifier [NPI]: | 1528148418 |
| Last Name Of The Provider | EBRAHIM |
| First Name Of The Provider | FARHAD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2658 W. LASKEY ROAD |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436133288 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 212 |
| Number Of Services | 3966 |
| Number Of Medicare Beneficiaries | 2385 |
| Total Submitted Charge Amount | 530474.5 |
| Total Medicare Allowed Amount | 141295.89 |
| Total Medicare Payment Amount | 108012.69 |
| Total Medicare Standardized Payment Amount | 111384.2 |
| 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 | 212 |
| Number Of Medical Services | 3966 |
| Number Of Medicare Beneficiaries With Medical Services | 2385 |
| Total Medical Submitted Charge Amount | 530474.5 |
| Total Medical Medicare Allowed Amount | 141295.89 |
| Total Medical Medicare Payment Amount | 108012.69 |
| Total Medical Medicare Standardized Payment Amount | 111384.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 361 |
| Number Of Beneficiaries Age 65 to 74 | 923 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 423 |
| Number Of Female Beneficiaries | 1417 |
| Number Of Male Beneficiaries | 968 |
| Number Of Non Hispanic White Beneficiaries | 2165 |
| Number Of Black or African American Beneficiaries | 110 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1931 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 454 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5345 |