| National Provider Identifier [NPI]: | 1891890430 |
| Last Name Of The Provider | ALSAFWAH |
| First Name Of The Provider | SHADWAN |
| 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 | 1407 UNION AVE |
| Street Address 2 Of The Provider | SUITE # 200 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381043600 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 5388 |
| Number Of Medicare Beneficiaries | 2126 |
| Total Submitted Charge Amount | 1231624 |
| Total Medicare Allowed Amount | 396806.52 |
| Total Medicare Payment Amount | 304430.23 |
| Total Medicare Standardized Payment Amount | 328151.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 5388 |
| Number Of Medicare Beneficiaries With Medical Services | 2126 |
| Total Medical Submitted Charge Amount | 1231624 |
| Total Medical Medicare Allowed Amount | 396806.52 |
| Total Medical Medicare Payment Amount | 304430.23 |
| Total Medical Medicare Standardized Payment Amount | 328151.77 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 738 |
| Number Of Beneficiaries Age 65 to 74 | 688 |
| Number Of Beneficiaries Age 75 to 84 | 464 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 1177 |
| Number Of Male Beneficiaries | 949 |
| Number Of Non Hispanic White Beneficiaries | 698 |
| Number Of Black or African American Beneficiaries | 1395 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1083 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1043 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.9194 |