| National Provider Identifier [NPI]: | 1710920582 |
| Last Name Of The Provider | YEGANEH |
| First Name Of The Provider | FREDERIC |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| 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 | 74 |
| Number Of Services | 6718 |
| Number Of Medicare Beneficiaries | 3134 |
| Total Submitted Charge Amount | 3792804.59 |
| Total Medicare Allowed Amount | 1791651.9 |
| Total Medicare Payment Amount | 1387540.16 |
| Total Medicare Standardized Payment Amount | 1370420.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1600 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 580.06 |
| Total Drug Medicare AllowedAmount | 508.46 |
| Total Drug Medicare PaymentAmount | 395.61 |
| Total Drug Medicare Standardized Payment Amount | 395.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 5118 |
| Number Of Medicare Beneficiaries With Medical Services | 3134 |
| Total Medical Submitted Charge Amount | 3792224.53 |
| Total Medical Medicare Allowed Amount | 1791143.44 |
| Total Medical Medicare Payment Amount | 1387144.55 |
| Total Medical Medicare Standardized Payment Amount | 1370024.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 333 |
| Number Of Beneficiaries Age 65 to 74 | 1371 |
| Number Of Beneficiaries Age 75 to 84 | 984 |
| Number Of Beneficiaries Age Greater 84 | 446 |
| Number Of Female Beneficiaries | 1809 |
| Number Of Male Beneficiaries | 1325 |
| Number Of Non Hispanic White Beneficiaries | 2633 |
| Number Of Black or African American Beneficiaries | 389 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 373 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 36 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6986 |