| National Provider Identifier [NPI]: | 1922057967 |
| Last Name Of The Provider | HUSSAIN |
| First Name Of The Provider | SHAHID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 988102 NEBRASKA MEDICAL CTR |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681988102 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 1855 |
| Number Of Medicare Beneficiaries | 1297 |
| Total Submitted Charge Amount | 398731.9 |
| Total Medicare Allowed Amount | 136963.07 |
| Total Medicare Payment Amount | 102364.3 |
| Total Medicare Standardized Payment Amount | 109562.32 |
| 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 | 43 |
| Number Of Medical Services | 1855 |
| Number Of Medicare Beneficiaries With Medical Services | 1297 |
| Total Medical Submitted Charge Amount | 398731.9 |
| Total Medical Medicare Allowed Amount | 136963.07 |
| Total Medical Medicare Payment Amount | 102364.3 |
| Total Medical Medicare Standardized Payment Amount | 109562.32 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 371 |
| Number Of Beneficiaries Age 65 to 74 | 485 |
| Number Of Beneficiaries Age 75 to 84 | 344 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 670 |
| Number Of Male Beneficiaries | 627 |
| Number Of Non Hispanic White Beneficiaries | 1088 |
| Number Of Black or African American Beneficiaries | 131 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 941 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 356 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.1509 |