| National Provider Identifier [NPI]: | 1649332172 |
| Last Name Of The Provider | DALAL |
| First Name Of The Provider | KSHITIJ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 S GREENE ST |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011544 |
| 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 | 71 |
| Number Of Services | 10854 |
| Number Of Medicare Beneficiaries | 2938 |
| Total Submitted Charge Amount | 810845 |
| Total Medicare Allowed Amount | 252093.66 |
| Total Medicare Payment Amount | 191430.69 |
| Total Medicare Standardized Payment Amount | 194681.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6941 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 4163.21 |
| Total Drug Medicare AllowedAmount | 2244.04 |
| Total Drug Medicare PaymentAmount | 1739.08 |
| Total Drug Medicare Standardized Payment Amount | 1739.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 3913 |
| Number Of Medicare Beneficiaries With Medical Services | 2934 |
| Total Medical Submitted Charge Amount | 806681.79 |
| Total Medical Medicare Allowed Amount | 249849.62 |
| Total Medical Medicare Payment Amount | 189691.61 |
| Total Medical Medicare Standardized Payment Amount | 192942 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 523 |
| Number Of Beneficiaries Age 65 to 74 | 900 |
| Number Of Beneficiaries Age 75 to 84 | 886 |
| Number Of Beneficiaries Age Greater 84 | 629 |
| Number Of Female Beneficiaries | 1752 |
| Number Of Male Beneficiaries | 1186 |
| Number Of Non Hispanic White Beneficiaries | 2078 |
| Number Of Black or African American Beneficiaries | 303 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 479 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2066 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 872 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 1.965 |