National Provider Identifier [NPI]: |
1588754055 |
Last Name Of The Provider |
FAHDI |
First Name Of The Provider |
IBRAHIM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1717 N E ST |
Street Address 2 Of The Provider |
SUITE 331 |
City Of The Provider |
PENSACOLA |
Zip Code Of The Provider |
325016376 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
4481 |
Number Of Medicare Beneficiaries |
2255 |
Total Submitted Charge Amount |
557060 |
Total Medicare Allowed Amount |
249569.63 |
Total Medicare Payment Amount |
190427.38 |
Total Medicare Standardized Payment Amount |
191911.9 |
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 |
55 |
Number Of Medical Services |
4481 |
Number Of Medicare Beneficiaries With Medical Services |
2255 |
Total Medical Submitted Charge Amount |
557060 |
Total Medical Medicare Allowed Amount |
249569.63 |
Total Medical Medicare Payment Amount |
190427.38 |
Total Medical Medicare Standardized Payment Amount |
191911.9 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
367 |
Number Of Beneficiaries Age 65 to 74 |
822 |
Number Of Beneficiaries Age 75 to 84 |
717 |
Number Of Beneficiaries Age Greater 84 |
349 |
Number Of Female Beneficiaries |
1146 |
Number Of Male Beneficiaries |
1109 |
Number Of Non Hispanic White Beneficiaries |
1784 |
Number Of Black or African American Beneficiaries |
392 |
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
17 |
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
1695 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
560 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7108 |