| National Provider Identifier [NPI]: | 1700841566 |
| Last Name Of The Provider | NASRALLAH |
| First Name Of The Provider | AMMAR |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1313 FISH HATCHERY RD |
| Street Address 2 Of The Provider | DEAN CLINIC |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537151911 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 50625 |
| Number Of Medicare Beneficiaries | 511 |
| Total Submitted Charge Amount | 1512628.3 |
| Total Medicare Allowed Amount | 668031.04 |
| Total Medicare Payment Amount | 521890.23 |
| Total Medicare Standardized Payment Amount | 526229.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 42 |
| Number Of Drug Services | 48391 |
| Number Of Medicare Beneficiaries With Drug Services | 187 |
| Total Drug Submitted ChargeAmount | 971226.25 |
| Total Drug Medicare AllowedAmount | 502658.73 |
| Total Drug Medicare PaymentAmount | 393688.62 |
| Total Drug Medicare Standardized Payment Amount | 393688.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 2234 |
| Number Of Medicare Beneficiaries With Medical Services | 511 |
| Total Medical Submitted Charge Amount | 541402.05 |
| Total Medical Medicare Allowed Amount | 165372.31 |
| Total Medical Medicare Payment Amount | 128201.61 |
| Total Medical Medicare Standardized Payment Amount | 132541.04 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 473 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 336 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 2.0767 |