| National Provider Identifier [NPI]: | 1033366877 |
| Last Name Of The Provider | HUSSIEN |
| First Name Of The Provider | AMIRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MBBCH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 169 RIVERSIDE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BINGHAMTON |
| Zip Code Of The Provider | 139054246 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 139 |
| Number Of Services | 3884 |
| Number Of Medicare Beneficiaries | 1842 |
| Total Submitted Charge Amount | 376495.92 |
| Total Medicare Allowed Amount | 102008.69 |
| Total Medicare Payment Amount | 79037.88 |
| Total Medicare Standardized Payment Amount | 82236.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 992 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 257.92 |
| Total Drug Medicare AllowedAmount | 229.35 |
| Total Drug Medicare PaymentAmount | 179.81 |
| Total Drug Medicare Standardized Payment Amount | 179.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 2892 |
| Number Of Medicare Beneficiaries With Medical Services | 1842 |
| Total Medical Submitted Charge Amount | 376238 |
| Total Medical Medicare Allowed Amount | 101779.34 |
| Total Medical Medicare Payment Amount | 78858.07 |
| Total Medical Medicare Standardized Payment Amount | 82056.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 446 |
| Number Of Beneficiaries Age 65 to 74 | 593 |
| Number Of Beneficiaries Age 75 to 84 | 501 |
| Number Of Beneficiaries Age Greater 84 | 302 |
| Number Of Female Beneficiaries | 1041 |
| Number Of Male Beneficiaries | 801 |
| Number Of Non Hispanic White Beneficiaries | 1534 |
| Number Of Black or African American Beneficiaries | 229 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 597 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8707 |