| National Provider Identifier [NPI]: | 1174521009 |
| Last Name Of The Provider | AHMAD |
| First Name Of The Provider | IMTIAZ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16420 HEALTHPARK COMMONS DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339089621 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 12027 |
| Number Of Medicare Beneficiaries | 800 |
| Total Submitted Charge Amount | 2273932.26 |
| Total Medicare Allowed Amount | 707996.93 |
| Total Medicare Payment Amount | 543208.04 |
| Total Medicare Standardized Payment Amount | 525309.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 5870 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 12190.08 |
| Total Drug Medicare AllowedAmount | 4201.6 |
| Total Drug Medicare PaymentAmount | 3511.35 |
| Total Drug Medicare Standardized Payment Amount | 3511.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 6157 |
| Number Of Medicare Beneficiaries With Medical Services | 800 |
| Total Medical Submitted Charge Amount | 2261742.18 |
| Total Medical Medicare Allowed Amount | 703795.33 |
| Total Medical Medicare Payment Amount | 539696.69 |
| Total Medical Medicare Standardized Payment Amount | 521798.14 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 301 |
| Number Of Beneficiaries Age 75 to 84 | 236 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 426 |
| Number Of Male Beneficiaries | 374 |
| Number Of Non Hispanic White Beneficiaries | 665 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 594 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 206 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 67 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.1595 |