National Provider Identifier [NPI]: |
1396997912 |
Last Name Of The Provider |
IBRAHIM |
First Name Of The Provider |
FADI |
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 |
1920 LIVERNOIS RD |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
TROY |
Zip Code Of The Provider |
480831732 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2852 |
Number Of Medicare Beneficiaries |
523 |
Total Submitted Charge Amount |
483614.68 |
Total Medicare Allowed Amount |
296946.97 |
Total Medicare Payment Amount |
230032.12 |
Total Medicare Standardized Payment Amount |
231869.52 |
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 |
18 |
Number Of Medical Services |
2852 |
Number Of Medicare Beneficiaries With Medical Services |
523 |
Total Medical Submitted Charge Amount |
483614.68 |
Total Medical Medicare Allowed Amount |
296946.97 |
Total Medical Medicare Payment Amount |
230032.12 |
Total Medical Medicare Standardized Payment Amount |
231869.52 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
384 |
Number Of Black or African American Beneficiaries |
117 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
298 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
59 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
67 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.8506 |