| National Provider Identifier [NPI]: | 1497726673 |
| Last Name Of The Provider | DADA |
| First Name Of The Provider | SHAMIM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 E ANTIETAM ST |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | HAGERSTOWN |
| Zip Code Of The Provider | 217405794 |
| 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 | 162 |
| Number Of Services | 14909 |
| Number Of Medicare Beneficiaries | 2269 |
| Total Submitted Charge Amount | 805774.8 |
| Total Medicare Allowed Amount | 216522.1 |
| Total Medicare Payment Amount | 166388.92 |
| Total Medicare Standardized Payment Amount | 165516.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11391 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 10795.8 |
| Total Drug Medicare AllowedAmount | 2941.66 |
| Total Drug Medicare PaymentAmount | 2292.48 |
| Total Drug Medicare Standardized Payment Amount | 2292.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 3518 |
| Number Of Medicare Beneficiaries With Medical Services | 2269 |
| Total Medical Submitted Charge Amount | 794979 |
| Total Medical Medicare Allowed Amount | 213580.44 |
| Total Medical Medicare Payment Amount | 164096.44 |
| Total Medical Medicare Standardized Payment Amount | 163224.5 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 356 |
| Number Of Beneficiaries Age 65 to 74 | 772 |
| Number Of Beneficiaries Age 75 to 84 | 667 |
| Number Of Beneficiaries Age Greater 84 | 474 |
| Number Of Female Beneficiaries | 1365 |
| Number Of Male Beneficiaries | 904 |
| Number Of Non Hispanic White Beneficiaries | 1864 |
| Number Of Black or African American Beneficiaries | 268 |
| Number Of AsianPacific Islander Beneficiaries | 67 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1770 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 499 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7853 |