| National Provider Identifier [NPI]: | 1104803212 |
| Last Name Of The Provider | AHMAD |
| First Name Of The Provider | IMTIAZ |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11580 OVERLOOK DRIVE, SUITE100 |
| Street Address 2 Of The Provider | CLARIAN URGENT CARE |
| City Of The Provider | FISHERS |
| Zip Code Of The Provider | 460384212 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 726 |
| Number Of Medicare Beneficiaries | 403 |
| Total Submitted Charge Amount | 118498 |
| Total Medicare Allowed Amount | 55846.11 |
| Total Medicare Payment Amount | 37798.51 |
| Total Medicare Standardized Payment Amount | 41810.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 87 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1815 |
| Total Drug Medicare AllowedAmount | 321.14 |
| Total Drug Medicare PaymentAmount | 264.99 |
| Total Drug Medicare Standardized Payment Amount | 264.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 639 |
| Number Of Medicare Beneficiaries With Medical Services | 403 |
| Total Medical Submitted Charge Amount | 116683 |
| Total Medical Medicare Allowed Amount | 55524.97 |
| Total Medical Medicare Payment Amount | 37533.52 |
| Total Medical Medicare Standardized Payment Amount | 41545.33 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 174 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 252 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | 376 |
| Number Of Black or African American Beneficiaries | |
| 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 | 324 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9711 |