| National Provider Identifier [NPI]: | 1922271204 |
| Last Name Of The Provider | IDREES |
| First Name Of The Provider | IMRAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 314 S KIMBERLY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOMERSET |
| Zip Code Of The Provider | 155012223 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 44603 |
| Number Of Medicare Beneficiaries | 175 |
| Total Submitted Charge Amount | 1409215 |
| Total Medicare Allowed Amount | 503754.74 |
| Total Medicare Payment Amount | 390865.89 |
| Total Medicare Standardized Payment Amount | 391968.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 35 |
| Number Of Drug Services | 43276 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 1197294 |
| Total Drug Medicare AllowedAmount | 421629.23 |
| Total Drug Medicare PaymentAmount | 329877.12 |
| Total Drug Medicare Standardized Payment Amount | 329877.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1327 |
| Number Of Medicare Beneficiaries With Medical Services | 175 |
| Total Medical Submitted Charge Amount | 211921 |
| Total Medical Medicare Allowed Amount | 82125.51 |
| Total Medical Medicare Payment Amount | 60988.77 |
| Total Medical Medicare Standardized Payment Amount | 62091.29 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 175 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.0917 |