| National Provider Identifier [NPI]: | 1700866316 |
| Last Name Of The Provider | BASS |
| First Name Of The Provider | RITA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8926 WOODYARD RD |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 207354220 |
| 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 | 109 |
| Number Of Services | 6375 |
| Number Of Medicare Beneficiaries | 1480 |
| Total Submitted Charge Amount | 539419 |
| Total Medicare Allowed Amount | 206241.86 |
| Total Medicare Payment Amount | 159375.3 |
| Total Medicare Standardized Payment Amount | 156304.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4100 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 1558 |
| Total Drug Medicare AllowedAmount | 745.92 |
| Total Drug Medicare PaymentAmount | 576.55 |
| Total Drug Medicare Standardized Payment Amount | 576.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 2275 |
| Number Of Medicare Beneficiaries With Medical Services | 1480 |
| Total Medical Submitted Charge Amount | 537861 |
| Total Medical Medicare Allowed Amount | 205495.94 |
| Total Medical Medicare Payment Amount | 158798.75 |
| Total Medical Medicare Standardized Payment Amount | 155727.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 824 |
| Number Of Beneficiaries Age 75 to 84 | 420 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 1102 |
| Number Of Male Beneficiaries | 378 |
| Number Of Non Hispanic White Beneficiaries | 942 |
| Number Of Black or African American Beneficiaries | 428 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1323 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 157 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0138 |