| National Provider Identifier [NPI]: | 1912950304 |
| Last Name Of The Provider | CAMMOUN |
| First Name Of The Provider | DRISS |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4006 JOHNATHAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERLOO |
| Zip Code Of The Provider | 507019395 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 183 |
| Number Of Services | 96662 |
| Number Of Medicare Beneficiaries | 2308 |
| Total Submitted Charge Amount | 5149643 |
| Total Medicare Allowed Amount | 1149772.23 |
| Total Medicare Payment Amount | 888247.32 |
| Total Medicare Standardized Payment Amount | 944557.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 88802 |
| Number Of Medicare Beneficiaries With Drug Services | 820 |
| Total Drug Submitted ChargeAmount | 215380 |
| Total Drug Medicare AllowedAmount | 27152.62 |
| Total Drug Medicare PaymentAmount | 21165.78 |
| Total Drug Medicare Standardized Payment Amount | 21165.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 7860 |
| Number Of Medicare Beneficiaries With Medical Services | 2299 |
| Total Medical Submitted Charge Amount | 4934263 |
| Total Medical Medicare Allowed Amount | 1122619.61 |
| Total Medical Medicare Payment Amount | 867081.54 |
| Total Medical Medicare Standardized Payment Amount | 923391.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 313 |
| Number Of Beneficiaries Age 65 to 74 | 1038 |
| Number Of Beneficiaries Age 75 to 84 | 704 |
| Number Of Beneficiaries Age Greater 84 | 253 |
| Number Of Female Beneficiaries | 1366 |
| Number Of Male Beneficiaries | 942 |
| Number Of Non Hispanic White Beneficiaries | 2164 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1983 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 325 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3024 |