| National Provider Identifier [NPI]: | 1760620280 |
| Last Name Of The Provider | DAHER |
| First Name Of The Provider | RALPH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 DODSON AVE |
| Street Address 2 Of The Provider | STE 280 |
| City Of The Provider | FORT SMITH |
| Zip Code Of The Provider | 729015182 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1817 |
| Number Of Medicare Beneficiaries | 541 |
| Total Submitted Charge Amount | 503322.13 |
| Total Medicare Allowed Amount | 175550.31 |
| Total Medicare Payment Amount | 134048.14 |
| Total Medicare Standardized Payment Amount | 143346.34 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 427 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 55 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 352 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 3.4813 |