| National Provider Identifier [NPI]: | 1376578369 |
| Last Name Of The Provider | URBAN |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2722 MERRILEE DR |
| Street Address 2 Of The Provider | #230 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314400 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 25180 |
| Number Of Medicare Beneficiaries | 2150 |
| Total Submitted Charge Amount | 1145587.2 |
| Total Medicare Allowed Amount | 228861.59 |
| Total Medicare Payment Amount | 173963.26 |
| Total Medicare Standardized Payment Amount | 157058.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 22080 |
| Number Of Medicare Beneficiaries With Drug Services | 215 |
| Total Drug Submitted ChargeAmount | 31708.2 |
| Total Drug Medicare AllowedAmount | 4826.89 |
| Total Drug Medicare PaymentAmount | 3475.37 |
| Total Drug Medicare Standardized Payment Amount | 3475.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 3100 |
| Number Of Medicare Beneficiaries With Medical Services | 2147 |
| Total Medical Submitted Charge Amount | 1113879 |
| Total Medical Medicare Allowed Amount | 224034.7 |
| Total Medical Medicare Payment Amount | 170487.89 |
| Total Medical Medicare Standardized Payment Amount | 153582.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 906 |
| Number Of Beneficiaries Age 75 to 84 | 696 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1233 |
| Number Of Male Beneficiaries | 917 |
| Number Of Non Hispanic White Beneficiaries | 1596 |
| Number Of Black or African American Beneficiaries | 159 |
| Number Of AsianPacific Islander Beneficiaries | 221 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1795 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 355 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| 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 | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4662 |