| National Provider Identifier [NPI]: | 1346224763 |
| Last Name Of The Provider | FEDOVSKIY |
| First Name Of The Provider | ALEKSANDR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PAAA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1968 PEACHTREE RD., NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303091281 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiologist Assistants |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 245 |
| Number Of Medicare Beneficiaries | 237 |
| Total Submitted Charge Amount | 161641.44 |
| Total Medicare Allowed Amount | 29292.33 |
| Total Medicare Payment Amount | 22777.91 |
| Total Medicare Standardized Payment Amount | 22955.44 |
| 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 | 47 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 237 |
| Total Medical Submitted Charge Amount | 161641.44 |
| Total Medical Medicare Allowed Amount | 29292.33 |
| Total Medical Medicare Payment Amount | 22777.91 |
| Total Medical Medicare Standardized Payment Amount | 22955.44 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 112 |
| Number Of Non Hispanic White Beneficiaries | 165 |
| Number Of Black or African American Beneficiaries | 56 |
| 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 | 188 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8162 |