| National Provider Identifier [NPI]: | 1073682696 |
| Last Name Of The Provider | ABDULLAH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LEE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| 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 | 79 |
| Number Of Services | 11117 |
| Number Of Medicare Beneficiaries | 1951 |
| Total Submitted Charge Amount | 3059021 |
| Total Medicare Allowed Amount | 321515.93 |
| Total Medicare Payment Amount | 241173.54 |
| Total Medicare Standardized Payment Amount | 255928.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7193 |
| Number Of Medicare Beneficiaries With Drug Services | 374 |
| Total Drug Submitted ChargeAmount | 33782 |
| Total Drug Medicare AllowedAmount | 2949.03 |
| Total Drug Medicare PaymentAmount | 2289.84 |
| Total Drug Medicare Standardized Payment Amount | 2289.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 3924 |
| Number Of Medicare Beneficiaries With Medical Services | 1951 |
| Total Medical Submitted Charge Amount | 3025239 |
| Total Medical Medicare Allowed Amount | 318566.9 |
| Total Medical Medicare Payment Amount | 238883.7 |
| Total Medical Medicare Standardized Payment Amount | 253638.52 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 461 |
| Number Of Beneficiaries Age 65 to 74 | 774 |
| Number Of Beneficiaries Age 75 to 84 | 528 |
| Number Of Beneficiaries Age Greater 84 | 188 |
| Number Of Female Beneficiaries | 1014 |
| Number Of Male Beneficiaries | 937 |
| Number Of Non Hispanic White Beneficiaries | 1663 |
| Number Of Black or African American Beneficiaries | 237 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 15 |
| 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 | 1512 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 439 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.5743 |