| National Provider Identifier [NPI]: | 1952300576 |
| Last Name Of The Provider | ALI |
| First Name Of The Provider | KAMRAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 551 N HILLSIDE ST |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672144923 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 212 |
| Number Of Services | 7032 |
| Number Of Medicare Beneficiaries | 3024 |
| Total Submitted Charge Amount | 837413.81 |
| Total Medicare Allowed Amount | 281677.01 |
| Total Medicare Payment Amount | 231308.21 |
| Total Medicare Standardized Payment Amount | 251431.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1934 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 821.4 |
| Total Drug Medicare AllowedAmount | 762.25 |
| Total Drug Medicare PaymentAmount | 574.45 |
| Total Drug Medicare Standardized Payment Amount | 574.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 210 |
| Number Of Medical Services | 5098 |
| Number Of Medicare Beneficiaries With Medical Services | 3024 |
| Total Medical Submitted Charge Amount | 836592.41 |
| Total Medical Medicare Allowed Amount | 280914.76 |
| Total Medical Medicare Payment Amount | 230733.76 |
| Total Medical Medicare Standardized Payment Amount | 250856.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 515 |
| Number Of Beneficiaries Age 65 to 74 | 1132 |
| Number Of Beneficiaries Age 75 to 84 | 899 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 2118 |
| Number Of Male Beneficiaries | 906 |
| Number Of Non Hispanic White Beneficiaries | 2671 |
| Number Of Black or African American Beneficiaries | 187 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2453 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 571 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4634 |