| National Provider Identifier [NPI]: | 1033159629 |
| Last Name Of The Provider | IBRAHIM |
| First Name Of The Provider | FADI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 COLLINS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381123814 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 10813 |
| Number Of Medicare Beneficiaries | 3749 |
| Total Submitted Charge Amount | 2322661.96 |
| Total Medicare Allowed Amount | 653200.63 |
| Total Medicare Payment Amount | 496646.03 |
| Total Medicare Standardized Payment Amount | 340348.6 |
| 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 | 14 |
| Number Of Medical Services | 10813 |
| Number Of Medicare Beneficiaries With Medical Services | 3749 |
| Total Medical Submitted Charge Amount | 2322661.96 |
| Total Medical Medicare Allowed Amount | 653200.63 |
| Total Medical Medicare Payment Amount | 496646.03 |
| Total Medical Medicare Standardized Payment Amount | 340348.6 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 640 |
| Number Of Beneficiaries Age 65 to 74 | 2031 |
| Number Of Beneficiaries Age 75 to 84 | 963 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 2138 |
| Number Of Male Beneficiaries | 1611 |
| Number Of Non Hispanic White Beneficiaries | 3230 |
| Number Of Black or African American Beneficiaries | 320 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3084 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 665 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0339 |