| National Provider Identifier [NPI]: | 1386756534 |
| Last Name Of The Provider | AHMAD |
| First Name Of The Provider | KHADIJAH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 220 24TH ST SOUTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | WISC RAPIDS |
| Zip Code Of The Provider | 54494 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 20348 |
| Number Of Medicare Beneficiaries | 571 |
| Total Submitted Charge Amount | 929326.8 |
| Total Medicare Allowed Amount | 334828.24 |
| Total Medicare Payment Amount | 259610.4 |
| Total Medicare Standardized Payment Amount | 264739.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 60 |
| Number Of Drug Services | 15734 |
| Number Of Medicare Beneficiaries With Drug Services | 265 |
| Total Drug Submitted ChargeAmount | 330145.35 |
| Total Drug Medicare AllowedAmount | 177124.13 |
| Total Drug Medicare PaymentAmount | 139380.45 |
| Total Drug Medicare Standardized Payment Amount | 139380.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 4614 |
| Number Of Medicare Beneficiaries With Medical Services | 570 |
| Total Medical Submitted Charge Amount | 599181.45 |
| Total Medical Medicare Allowed Amount | 157704.11 |
| Total Medical Medicare Payment Amount | 120229.95 |
| Total Medical Medicare Standardized Payment Amount | 125359.07 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 367 |
| Number Of Male Beneficiaries | 204 |
| Number Of Non Hispanic White Beneficiaries | 543 |
| 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 | 360 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 211 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.3556 |