| National Provider Identifier [NPI]: | 1679726285 |
| Last Name Of The Provider | HABIB |
| First Name Of The Provider | AMOS |
| Middle Initial Of The Provider | Q |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1508 WILLOW LAWN DR |
| Street Address 2 Of The Provider | STE 117 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232303421 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 219 |
| Number Of Services | 4873 |
| Number Of Medicare Beneficiaries | 3329 |
| Total Submitted Charge Amount | 928810 |
| Total Medicare Allowed Amount | 349817.84 |
| Total Medicare Payment Amount | 264519.39 |
| Total Medicare Standardized Payment Amount | 270292.14 |
| 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 | 219 |
| Number Of Medical Services | 4873 |
| Number Of Medicare Beneficiaries With Medical Services | 3329 |
| Total Medical Submitted Charge Amount | 928810 |
| Total Medical Medicare Allowed Amount | 349817.84 |
| Total Medical Medicare Payment Amount | 264519.39 |
| Total Medical Medicare Standardized Payment Amount | 270292.14 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 491 |
| Number Of Beneficiaries Age 65 to 74 | 1484 |
| Number Of Beneficiaries Age 75 to 84 | 921 |
| Number Of Beneficiaries Age Greater 84 | 433 |
| Number Of Female Beneficiaries | 2002 |
| Number Of Male Beneficiaries | 1327 |
| Number Of Non Hispanic White Beneficiaries | 2484 |
| Number Of Black or African American Beneficiaries | 750 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2807 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 522 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.5891 |