| National Provider Identifier [NPI]: | 1114917820 |
| Last Name Of The Provider | GHARIB |
| First Name Of The Provider | MOHSEN |
| 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 | 3001 S HANOVER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212251233 |
| 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 | 156 |
| Number Of Services | 4912 |
| Number Of Medicare Beneficiaries | 2176 |
| Total Submitted Charge Amount | 374196 |
| Total Medicare Allowed Amount | 134601.21 |
| Total Medicare Payment Amount | 99489.52 |
| Total Medicare Standardized Payment Amount | 96084.36 |
| 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 | 156 |
| Number Of Medical Services | 4912 |
| Number Of Medicare Beneficiaries With Medical Services | 2176 |
| Total Medical Submitted Charge Amount | 374196 |
| Total Medical Medicare Allowed Amount | 134601.21 |
| Total Medical Medicare Payment Amount | 99489.52 |
| Total Medical Medicare Standardized Payment Amount | 96084.36 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 714 |
| Number Of Beneficiaries Age 65 to 74 | 711 |
| Number Of Beneficiaries Age 75 to 84 | 502 |
| Number Of Beneficiaries Age Greater 84 | 249 |
| Number Of Female Beneficiaries | 1353 |
| Number Of Male Beneficiaries | 823 |
| Number Of Non Hispanic White Beneficiaries | 1449 |
| Number Of Black or African American Beneficiaries | 659 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1349 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 827 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8675 |