| National Provider Identifier [NPI]: | 1275636805 |
| Last Name Of The Provider | ULLAH |
| First Name Of The Provider | FARID |
| 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 | 1340 S 18TH ST |
| Street Address 2 Of The Provider | CREDENTIALING DEPARTMENT |
| City Of The Provider | FERNANDINA BEACH |
| Zip Code Of The Provider | 320344799 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 11558 |
| Number Of Medicare Beneficiaries | 2143 |
| Total Submitted Charge Amount | 1093099.53 |
| Total Medicare Allowed Amount | 480744.4 |
| Total Medicare Payment Amount | 358753.98 |
| Total Medicare Standardized Payment Amount | 365503.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4366 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 36742 |
| Total Drug Medicare AllowedAmount | 18727.35 |
| Total Drug Medicare PaymentAmount | 14679.86 |
| Total Drug Medicare Standardized Payment Amount | 14679.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 7192 |
| Number Of Medicare Beneficiaries With Medical Services | 2143 |
| Total Medical Submitted Charge Amount | 1056357.53 |
| Total Medical Medicare Allowed Amount | 462017.05 |
| Total Medical Medicare Payment Amount | 344074.12 |
| Total Medical Medicare Standardized Payment Amount | 350823.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 243 |
| Number Of Beneficiaries Age 65 to 74 | 866 |
| Number Of Beneficiaries Age 75 to 84 | 676 |
| Number Of Beneficiaries Age Greater 84 | 358 |
| Number Of Female Beneficiaries | 1170 |
| Number Of Male Beneficiaries | 973 |
| Number Of Non Hispanic White Beneficiaries | 1923 |
| Number Of Black or African American Beneficiaries | 147 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1788 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 355 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4993 |