| National Provider Identifier [NPI]: | 1366515298 |
| Last Name Of The Provider | ZAYNEH |
| First Name Of The Provider | IBRAHIM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2127 25TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTSMOUTH |
| Zip Code Of The Provider | 456623250 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 4802 |
| Number Of Medicare Beneficiaries | 1617 |
| Total Submitted Charge Amount | 667319.74 |
| Total Medicare Allowed Amount | 340024.6 |
| Total Medicare Payment Amount | 243086.9 |
| Total Medicare Standardized Payment Amount | 253842.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 203 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 2512.2 |
| Total Drug Medicare AllowedAmount | 706.91 |
| Total Drug Medicare PaymentAmount | 548.44 |
| Total Drug Medicare Standardized Payment Amount | 548.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 4599 |
| Number Of Medicare Beneficiaries With Medical Services | 1617 |
| Total Medical Submitted Charge Amount | 664807.54 |
| Total Medical Medicare Allowed Amount | 339317.69 |
| Total Medical Medicare Payment Amount | 242538.46 |
| Total Medical Medicare Standardized Payment Amount | 253294 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 594 |
| Number Of Beneficiaries Age 75 to 84 | 557 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 820 |
| Number Of Male Beneficiaries | 797 |
| Number Of Non Hispanic White Beneficiaries | 1599 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 422 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2266 |