| National Provider Identifier [NPI]: | 1225000524 |
| Last Name Of The Provider | MUDARRIS |
| First Name Of The Provider | FAYSAL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21 CROSSROADS DR |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | OWINGS MILLS |
| Zip Code Of The Provider | 211175441 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 9655 |
| Number Of Medicare Beneficiaries | 4419 |
| Total Submitted Charge Amount | 845807.02 |
| Total Medicare Allowed Amount | 242223.12 |
| Total Medicare Payment Amount | 182766.14 |
| Total Medicare Standardized Payment Amount | 179066.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2445 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 562.35 |
| Total Drug Medicare AllowedAmount | 470.53 |
| Total Drug Medicare PaymentAmount | 346.42 |
| Total Drug Medicare Standardized Payment Amount | 346.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 7210 |
| Number Of Medicare Beneficiaries With Medical Services | 4419 |
| Total Medical Submitted Charge Amount | 845244.67 |
| Total Medical Medicare Allowed Amount | 241752.59 |
| Total Medical Medicare Payment Amount | 182419.72 |
| Total Medical Medicare Standardized Payment Amount | 178719.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 649 |
| Number Of Beneficiaries Age 65 to 74 | 1580 |
| Number Of Beneficiaries Age 75 to 84 | 1351 |
| Number Of Beneficiaries Age Greater 84 | 839 |
| Number Of Female Beneficiaries | 2705 |
| Number Of Male Beneficiaries | 1714 |
| Number Of Non Hispanic White Beneficiaries | 3876 |
| Number Of Black or African American Beneficiaries | 416 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3667 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 752 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6992 |