| National Provider Identifier [NPI]: | 1497739270 |
| Last Name Of The Provider | FALLAHI |
| First Name Of The Provider | SOHRAB |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1421 NARROW LANE PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTGOMERY |
| Zip Code Of The Provider | 361112654 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 109559 |
| Number Of Medicare Beneficiaries | 1114 |
| Total Submitted Charge Amount | 2533942.01 |
| Total Medicare Allowed Amount | 1877094.33 |
| Total Medicare Payment Amount | 1478710.98 |
| Total Medicare Standardized Payment Amount | 1521580.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 85419 |
| Number Of Medicare Beneficiaries With Drug Services | 584 |
| Total Drug Submitted ChargeAmount | 1365506.51 |
| Total Drug Medicare AllowedAmount | 1141532.05 |
| Total Drug Medicare PaymentAmount | 891026.55 |
| Total Drug Medicare Standardized Payment Amount | 891026.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 24140 |
| Number Of Medicare Beneficiaries With Medical Services | 1114 |
| Total Medical Submitted Charge Amount | 1168435.5 |
| Total Medical Medicare Allowed Amount | 735562.28 |
| Total Medical Medicare Payment Amount | 587684.43 |
| Total Medical Medicare Standardized Payment Amount | 630553.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 220 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 342 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 850 |
| Number Of Male Beneficiaries | 264 |
| Number Of Non Hispanic White Beneficiaries | 733 |
| Number Of Black or African American Beneficiaries | 366 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 947 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 23 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1465 |