| National Provider Identifier [NPI]: | 1104017250 |
| Last Name Of The Provider | STEVEN |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| 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 | ROOM N2E23 |
| 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 | 74 |
| Number Of Services | 3485 |
| Number Of Medicare Beneficiaries | 1461 |
| Total Submitted Charge Amount | 568747.16 |
| Total Medicare Allowed Amount | 147392.89 |
| Total Medicare Payment Amount | 113267.65 |
| Total Medicare Standardized Payment Amount | 109916.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1474 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1327.16 |
| Total Drug Medicare AllowedAmount | 685.93 |
| Total Drug Medicare PaymentAmount | 537.73 |
| Total Drug Medicare Standardized Payment Amount | 537.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 2011 |
| Number Of Medicare Beneficiaries With Medical Services | 1461 |
| Total Medical Submitted Charge Amount | 567420 |
| Total Medical Medicare Allowed Amount | 146706.96 |
| Total Medical Medicare Payment Amount | 112729.92 |
| Total Medical Medicare Standardized Payment Amount | 109379.11 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 409 |
| Number Of Beneficiaries Age 65 to 74 | 540 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 846 |
| Number Of Male Beneficiaries | 615 |
| Number Of Non Hispanic White Beneficiaries | 604 |
| Number Of Black or African American Beneficiaries | 799 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 921 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 540 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 2.5014 |