| National Provider Identifier [NPI]: | 1538198403 |
| Last Name Of The Provider | ALI |
| First Name Of The Provider | TEHMINA |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 S GREENE ST |
| Street Address 2 Of The Provider | NBW73 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011544 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 11174 |
| Number Of Medicare Beneficiaries | 4162 |
| Total Submitted Charge Amount | 4307261 |
| Total Medicare Allowed Amount | 2206580.8 |
| Total Medicare Payment Amount | 1705523.85 |
| Total Medicare Standardized Payment Amount | 1573908.48 |
| 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 | 15 |
| Number Of Medical Services | 11174 |
| Number Of Medicare Beneficiaries With Medical Services | 4162 |
| Total Medical Submitted Charge Amount | 4307261 |
| Total Medical Medicare Allowed Amount | 2206580.8 |
| Total Medical Medicare Payment Amount | 1705523.85 |
| Total Medical Medicare Standardized Payment Amount | 1573908.48 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 1857 |
| Number Of Beneficiaries Age 75 to 84 | 1437 |
| Number Of Beneficiaries Age Greater 84 | 646 |
| Number Of Female Beneficiaries | 1143 |
| Number Of Male Beneficiaries | 3019 |
| Number Of Non Hispanic White Beneficiaries | 3399 |
| Number Of Black or African American Beneficiaries | 589 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 82 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3863 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 299 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.194 |