| National Provider Identifier [NPI]: | 1699701730 |
| Last Name Of The Provider | FAYAD |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 N WOLFE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212870005 |
| 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 | 98 |
| Number Of Services | 1561 |
| Number Of Medicare Beneficiaries | 1056 |
| Total Submitted Charge Amount | 464238.7 |
| Total Medicare Allowed Amount | 101228.44 |
| Total Medicare Payment Amount | 75942.99 |
| Total Medicare Standardized Payment Amount | 73283.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1535.5 |
| Total Drug Medicare AllowedAmount | 11.59 |
| Total Drug Medicare PaymentAmount | 8.54 |
| Total Drug Medicare Standardized Payment Amount | 8.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 1541 |
| Number Of Medicare Beneficiaries With Medical Services | 1056 |
| Total Medical Submitted Charge Amount | 462703.2 |
| Total Medical Medicare Allowed Amount | 101216.85 |
| Total Medical Medicare Payment Amount | 75934.45 |
| Total Medical Medicare Standardized Payment Amount | 73274.7 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 438 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 492 |
| Number Of Non Hispanic White Beneficiaries | 653 |
| Number Of Black or African American Beneficiaries | 334 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 738 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 318 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1047 |