National Provider Identifier [NPI]: |
1720205511 |
Last Name Of The Provider |
FARID |
First Name Of The Provider |
WAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
282 FOREST PARK CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PANAMA CITY |
Zip Code Of The Provider |
324054919 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
803 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
162842 |
Total Medicare Allowed Amount |
67894.74 |
Total Medicare Payment Amount |
52769.92 |
Total Medicare Standardized Payment Amount |
52910.57 |
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 |
13 |
Number Of Medical Services |
803 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
162842 |
Total Medical Medicare Allowed Amount |
67894.74 |
Total Medical Medicare Payment Amount |
52769.92 |
Total Medical Medicare Standardized Payment Amount |
52910.57 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
128 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
57 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.118 |