| National Provider Identifier [NPI]: | 1902897895 |
| Last Name Of The Provider | DITTRICH |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2002 MEDICAL PKWY |
| Street Address 2 Of The Provider | SUITE #235 |
| City Of The Provider | ANNAPOLIS |
| Zip Code Of The Provider | 214013046 |
| 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 | 239 |
| Number Of Services | 30186 |
| Number Of Medicare Beneficiaries | 4338 |
| Total Submitted Charge Amount | 1739633.2 |
| Total Medicare Allowed Amount | 611447.25 |
| Total Medicare Payment Amount | 471544.01 |
| Total Medicare Standardized Payment Amount | 451816.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 23736 |
| Number Of Medicare Beneficiaries With Drug Services | 325 |
| Total Drug Submitted ChargeAmount | 27198 |
| Total Drug Medicare AllowedAmount | 5988.93 |
| Total Drug Medicare PaymentAmount | 4540.68 |
| Total Drug Medicare Standardized Payment Amount | 4540.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 235 |
| Number Of Medical Services | 6450 |
| Number Of Medicare Beneficiaries With Medical Services | 4334 |
| Total Medical Submitted Charge Amount | 1712435.2 |
| Total Medical Medicare Allowed Amount | 605458.32 |
| Total Medical Medicare Payment Amount | 467003.33 |
| Total Medical Medicare Standardized Payment Amount | 447275.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 429 |
| Number Of Beneficiaries Age 65 to 74 | 1795 |
| Number Of Beneficiaries Age 75 to 84 | 1385 |
| Number Of Beneficiaries Age Greater 84 | 729 |
| Number Of Female Beneficiaries | 2645 |
| Number Of Male Beneficiaries | 1693 |
| Number Of Non Hispanic White Beneficiaries | 3518 |
| Number Of Black or African American Beneficiaries | 690 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3906 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 432 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5266 |