| National Provider Identifier [NPI]: | 1457387375 |
| Last Name Of The Provider | FAISON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| 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 | 138 |
| Number Of Services | 45007 |
| Number Of Medicare Beneficiaries | 5171 |
| Total Submitted Charge Amount | 1857093.25 |
| Total Medicare Allowed Amount | 549074.1 |
| Total Medicare Payment Amount | 413559.52 |
| Total Medicare Standardized Payment Amount | 392054.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 37327 |
| Number Of Medicare Beneficiaries With Drug Services | 366 |
| Total Drug Submitted ChargeAmount | 8585.21 |
| Total Drug Medicare AllowedAmount | 6837.29 |
| Total Drug Medicare PaymentAmount | 4972.05 |
| Total Drug Medicare Standardized Payment Amount | 4972.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 7680 |
| Number Of Medicare Beneficiaries With Medical Services | 5171 |
| Total Medical Submitted Charge Amount | 1848508.04 |
| Total Medical Medicare Allowed Amount | 542236.81 |
| Total Medical Medicare Payment Amount | 408587.47 |
| Total Medical Medicare Standardized Payment Amount | 387082.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 788 |
| Number Of Beneficiaries Age 65 to 74 | 2093 |
| Number Of Beneficiaries Age 75 to 84 | 1543 |
| Number Of Beneficiaries Age Greater 84 | 747 |
| Number Of Female Beneficiaries | 3250 |
| Number Of Male Beneficiaries | 1921 |
| Number Of Non Hispanic White Beneficiaries | 4314 |
| Number Of Black or African American Beneficiaries | 623 |
| Number Of AsianPacific Islander Beneficiaries | 103 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 4376 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 795 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5519 |