| National Provider Identifier [NPI]: | 1508828195 |
| Last Name Of The Provider | IMAM |
| First Name Of The Provider | KHURSHEED |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 NORTHWEST BLVD |
| Street Address 2 Of The Provider | SUITE # 202 |
| City Of The Provider | COEUR D ALENE |
| Zip Code Of The Provider | 838142974 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 5860 |
| Number Of Medicare Beneficiaries | 3305 |
| Total Submitted Charge Amount | 775119.5 |
| Total Medicare Allowed Amount | 232366.87 |
| Total Medicare Payment Amount | 175144.29 |
| Total Medicare Standardized Payment Amount | 182028.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1253 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 16707 |
| Total Drug Medicare AllowedAmount | 2177.24 |
| Total Drug Medicare PaymentAmount | 1690.78 |
| Total Drug Medicare Standardized Payment Amount | 1690.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 4607 |
| Number Of Medicare Beneficiaries With Medical Services | 3305 |
| Total Medical Submitted Charge Amount | 758412.5 |
| Total Medical Medicare Allowed Amount | 230189.63 |
| Total Medical Medicare Payment Amount | 173453.51 |
| Total Medical Medicare Standardized Payment Amount | 180337.3 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 727 |
| Number Of Beneficiaries Age 65 to 74 | 1170 |
| Number Of Beneficiaries Age 75 to 84 | 921 |
| Number Of Beneficiaries Age Greater 84 | 487 |
| Number Of Female Beneficiaries | 1875 |
| Number Of Male Beneficiaries | 1430 |
| Number Of Non Hispanic White Beneficiaries | 2906 |
| Number Of Black or African American Beneficiaries | 334 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2441 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 864 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7012 |