| National Provider Identifier [NPI]: | 1396729505 |
| Last Name Of The Provider | DIAL |
| First Name Of The Provider | ALPHONSO |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 122 DEFENSE HWY |
| Street Address 2 Of The Provider | CHESAPEAKE MEDICAL IMAGING |
| City Of The Provider | ANNAPOLIS |
| Zip Code Of The Provider | 214017069 |
| 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 | 102 |
| Number Of Services | 10514 |
| Number Of Medicare Beneficiaries | 1524 |
| Total Submitted Charge Amount | 1265997 |
| Total Medicare Allowed Amount | 343856.93 |
| Total Medicare Payment Amount | 259046.7 |
| Total Medicare Standardized Payment Amount | 241494.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 8455 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 7005 |
| Total Drug Medicare AllowedAmount | 2536.45 |
| Total Drug Medicare PaymentAmount | 1964.73 |
| Total Drug Medicare Standardized Payment Amount | 1964.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 2059 |
| Number Of Medicare Beneficiaries With Medical Services | 1524 |
| Total Medical Submitted Charge Amount | 1258992 |
| Total Medical Medicare Allowed Amount | 341320.48 |
| Total Medical Medicare Payment Amount | 257081.97 |
| Total Medical Medicare Standardized Payment Amount | 239529.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 805 |
| Number Of Beneficiaries Age 75 to 84 | 424 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 878 |
| Number Of Male Beneficiaries | 646 |
| Number Of Non Hispanic White Beneficiaries | 1255 |
| Number Of Black or African American Beneficiaries | 199 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 18 |
| 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 | 1378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9997 |