| National Provider Identifier [NPI]: | 1780643288 |
| Last Name Of The Provider | HABRA |
| First Name Of The Provider | GHIYATH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 44201 DEQUINDRE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 480851117 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 4686 |
| Number Of Medicare Beneficiaries | 3252 |
| Total Submitted Charge Amount | 230817 |
| Total Medicare Allowed Amount | 122799.73 |
| Total Medicare Payment Amount | 91511.84 |
| Total Medicare Standardized Payment Amount | 89231.86 |
| 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 | 150 |
| Number Of Medical Services | 4686 |
| Number Of Medicare Beneficiaries With Medical Services | 3252 |
| Total Medical Submitted Charge Amount | 230817 |
| Total Medical Medicare Allowed Amount | 122799.73 |
| Total Medical Medicare Payment Amount | 91511.84 |
| Total Medical Medicare Standardized Payment Amount | 89231.86 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 442 |
| Number Of Beneficiaries Age 65 to 74 | 1200 |
| Number Of Beneficiaries Age 75 to 84 | 1000 |
| Number Of Beneficiaries Age Greater 84 | 610 |
| Number Of Female Beneficiaries | 1980 |
| Number Of Male Beneficiaries | 1272 |
| Number Of Non Hispanic White Beneficiaries | 2700 |
| Number Of Black or African American Beneficiaries | 356 |
| Number Of AsianPacific Islander Beneficiaries | 78 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 82 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2617 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 635 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0243 |