| National Provider Identifier [NPI]: | 1679740302 |
| Last Name Of The Provider | SAMAAN |
| First Name Of The Provider | BASSEM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 W OAK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KISSIMMEE |
| Zip Code Of The Provider | 347414924 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 6342 |
| Number Of Medicare Beneficiaries | 3637 |
| Total Submitted Charge Amount | 1296604 |
| Total Medicare Allowed Amount | 201026.38 |
| Total Medicare Payment Amount | 146694.2 |
| Total Medicare Standardized Payment Amount | 146217.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 221 |
| Number Of Medical Services | 6342 |
| Number Of Medicare Beneficiaries With Medical Services | 3637 |
| Total Medical Submitted Charge Amount | 1296604 |
| Total Medical Medicare Allowed Amount | 201026.38 |
| Total Medical Medicare Payment Amount | 146694.2 |
| Total Medical Medicare Standardized Payment Amount | 146217.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 728 |
| Number Of Beneficiaries Age 65 to 74 | 1146 |
| Number Of Beneficiaries Age 75 to 84 | 1067 |
| Number Of Beneficiaries Age Greater 84 | 696 |
| Number Of Female Beneficiaries | 2045 |
| Number Of Male Beneficiaries | 1592 |
| Number Of Non Hispanic White Beneficiaries | 2351 |
| Number Of Black or African American Beneficiaries | 452 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 746 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2441 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1196 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1053 |