| National Provider Identifier [NPI]: | 1811934698 |
| Last Name Of The Provider | IBRAHIM |
| First Name Of The Provider | RIMON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5607 DICKENSON HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLINTWOOD |
| Zip Code Of The Provider | 242287009 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 2720 |
| Number Of Medicare Beneficiaries | 646 |
| Total Submitted Charge Amount | 435481 |
| Total Medicare Allowed Amount | 182780.56 |
| Total Medicare Payment Amount | 127771.98 |
| Total Medicare Standardized Payment Amount | 135812.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 187 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 3396 |
| Total Drug Medicare AllowedAmount | 1435.94 |
| Total Drug Medicare PaymentAmount | 1369.02 |
| Total Drug Medicare Standardized Payment Amount | 1369.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 2533 |
| Number Of Medicare Beneficiaries With Medical Services | 646 |
| Total Medical Submitted Charge Amount | 432085 |
| Total Medical Medicare Allowed Amount | 181344.62 |
| Total Medical Medicare Payment Amount | 126402.96 |
| Total Medical Medicare Standardized Payment Amount | 134443.85 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 218 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 363 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 634 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 390 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 256 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4784 |