| National Provider Identifier [NPI]: | 1124005871 |
| Last Name Of The Provider | KHALIL |
| First Name Of The Provider | HANAN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | RHODE ISLAND MEDICAL IMAGING |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 4620 |
| Number Of Medicare Beneficiaries | 1782 |
| Total Submitted Charge Amount | 343137.5 |
| Total Medicare Allowed Amount | 123786.17 |
| Total Medicare Payment Amount | 103208.4 |
| Total Medicare Standardized Payment Amount | 100252.52 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 376 |
| Number Of Beneficiaries Age 65 to 74 | 814 |
| Number Of Beneficiaries Age 75 to 84 | 405 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 1513 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 1435 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 187 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1253 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 529 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2655 |