| National Provider Identifier [NPI]: | 1679517544 |
| Last Name Of The Provider | MISHNER |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| 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 | 154 |
| Number Of Services | 52658 |
| Number Of Medicare Beneficiaries | 4110 |
| Total Submitted Charge Amount | 1934900.52 |
| Total Medicare Allowed Amount | 558484.02 |
| Total Medicare Payment Amount | 419358.55 |
| Total Medicare Standardized Payment Amount | 399618.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 47599 |
| Number Of Medicare Beneficiaries With Drug Services | 467 |
| Total Drug Submitted ChargeAmount | 11566.68 |
| Total Drug Medicare AllowedAmount | 9256.18 |
| Total Drug Medicare PaymentAmount | 6546.63 |
| Total Drug Medicare Standardized Payment Amount | 6546.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 5059 |
| Number Of Medicare Beneficiaries With Medical Services | 4110 |
| Total Medical Submitted Charge Amount | 1923333.84 |
| Total Medical Medicare Allowed Amount | 549227.84 |
| Total Medical Medicare Payment Amount | 412811.92 |
| Total Medical Medicare Standardized Payment Amount | 393071.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 441 |
| Number Of Beneficiaries Age 65 to 74 | 1894 |
| Number Of Beneficiaries Age 75 to 84 | 1267 |
| Number Of Beneficiaries Age Greater 84 | 508 |
| Number Of Female Beneficiaries | 2660 |
| Number Of Male Beneficiaries | 1450 |
| Number Of Non Hispanic White Beneficiaries | 3158 |
| Number Of Black or African American Beneficiaries | 737 |
| Number Of AsianPacific Islander Beneficiaries | 99 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 73 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 489 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1881 |