| National Provider Identifier [NPI]: | 1124012653 |
| Last Name Of The Provider | ABAYEV |
| First Name Of The Provider | NISON |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10300 DIXIE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 40272 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 2500 |
| Number Of Medicare Beneficiaries | 299 |
| Total Submitted Charge Amount | 202011 |
| Total Medicare Allowed Amount | 107387.51 |
| Total Medicare Payment Amount | 73227.31 |
| Total Medicare Standardized Payment Amount | 81054.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 379 |
| Number Of Medicare Beneficiaries With Drug Services | 145 |
| Total Drug Submitted ChargeAmount | 7927 |
| Total Drug Medicare AllowedAmount | 4037.01 |
| Total Drug Medicare PaymentAmount | 3707.27 |
| Total Drug Medicare Standardized Payment Amount | 3707.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2121 |
| Number Of Medicare Beneficiaries With Medical Services | 299 |
| Total Medical Submitted Charge Amount | 194084 |
| Total Medical Medicare Allowed Amount | 103350.5 |
| Total Medical Medicare Payment Amount | 69520.04 |
| Total Medical Medicare Standardized Payment Amount | 77346.9 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 209 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 274 |
| 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 | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.323 |