| National Provider Identifier [NPI]: | 1922043330 |
| Last Name Of The Provider | FERNANDES |
| First Name Of The Provider | AUDREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| 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 | 153 |
| Number Of Services | 19446 |
| Number Of Medicare Beneficiaries | 3154 |
| Total Submitted Charge Amount | 1384121.04 |
| Total Medicare Allowed Amount | 404546.84 |
| Total Medicare Payment Amount | 302074.15 |
| Total Medicare Standardized Payment Amount | 285371.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 15135 |
| Number Of Medicare Beneficiaries With Drug Services | 220 |
| Total Drug Submitted ChargeAmount | 7089.6 |
| Total Drug Medicare AllowedAmount | 5340.05 |
| Total Drug Medicare PaymentAmount | 3861.81 |
| Total Drug Medicare Standardized Payment Amount | 3861.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 4311 |
| Number Of Medicare Beneficiaries With Medical Services | 3154 |
| Total Medical Submitted Charge Amount | 1377031.44 |
| Total Medical Medicare Allowed Amount | 399206.79 |
| Total Medical Medicare Payment Amount | 298212.34 |
| Total Medical Medicare Standardized Payment Amount | 281509.51 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 1342 |
| Number Of Beneficiaries Age 75 to 84 | 873 |
| Number Of Beneficiaries Age Greater 84 | 440 |
| Number Of Female Beneficiaries | 2024 |
| Number Of Male Beneficiaries | 1130 |
| Number Of Non Hispanic White Beneficiaries | 2492 |
| Number Of Black or African American Beneficiaries | 500 |
| Number Of AsianPacific Islander Beneficiaries | 81 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2635 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 519 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4965 |