| National Provider Identifier [NPI]: | 1326067455 |
| Last Name Of The Provider | IBRAHIM |
| First Name Of The Provider | FIKRY |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20825 MACK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GROSSE POINTE WOODS |
| Zip Code Of The Provider | 482361485 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 756 |
| Number Of Medicare Beneficiaries | 57 |
| Total Submitted Charge Amount | 108376 |
| Total Medicare Allowed Amount | 76428.26 |
| Total Medicare Payment Amount | 57600.81 |
| Total Medicare Standardized Payment Amount | 55996.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1589 |
| Total Drug Medicare AllowedAmount | 519.45 |
| Total Drug Medicare PaymentAmount | 453.19 |
| Total Drug Medicare Standardized Payment Amount | 453.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 677 |
| Number Of Medicare Beneficiaries With Medical Services | 57 |
| Total Medical Submitted Charge Amount | 106787 |
| Total Medical Medicare Allowed Amount | 75908.81 |
| Total Medical Medicare Payment Amount | 57147.62 |
| Total Medical Medicare Standardized Payment Amount | 55542.86 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 33 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | 29 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 65 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.522 |