| National Provider Identifier [NPI]: | 1538130265 |
| Last Name Of The Provider | FAKIR |
| First Name Of The Provider | SAMI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2213 CHERRY ST |
| Street Address 2 Of The Provider | MRG ASSOCIATES, LLC - RADIOLOGY DEPT - BASEMENT LEVEL |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436082603 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 203 |
| Number Of Services | 6472 |
| Number Of Medicare Beneficiaries | 3138 |
| Total Submitted Charge Amount | 418409.6 |
| Total Medicare Allowed Amount | 215915.64 |
| Total Medicare Payment Amount | 174590.98 |
| Total Medicare Standardized Payment Amount | 182325.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1100 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1377.6 |
| Total Drug Medicare AllowedAmount | 477.58 |
| Total Drug Medicare PaymentAmount | 374.45 |
| Total Drug Medicare Standardized Payment Amount | 374.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 201 |
| Number Of Medical Services | 5372 |
| Number Of Medicare Beneficiaries With Medical Services | 3138 |
| Total Medical Submitted Charge Amount | 417032 |
| Total Medical Medicare Allowed Amount | 215438.06 |
| Total Medical Medicare Payment Amount | 174216.53 |
| Total Medical Medicare Standardized Payment Amount | 181950.95 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 768 |
| Number Of Beneficiaries Age 65 to 74 | 1239 |
| Number Of Beneficiaries Age 75 to 84 | 795 |
| Number Of Beneficiaries Age Greater 84 | 336 |
| Number Of Female Beneficiaries | 2220 |
| Number Of Male Beneficiaries | 918 |
| Number Of Non Hispanic White Beneficiaries | 2533 |
| Number Of Black or African American Beneficiaries | 426 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 119 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 992 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.633 |