| National Provider Identifier [NPI]: | 1326170713 |
| Last Name Of The Provider | HUSAIN |
| First Name Of The Provider | MANSOOR |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 E ANTIETAM ST |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | HAGERSTOWN |
| Zip Code Of The Provider | 217405794 |
| 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 | 187 |
| Number Of Services | 28248 |
| Number Of Medicare Beneficiaries | 3766 |
| Total Submitted Charge Amount | 1347437.5 |
| Total Medicare Allowed Amount | 497229.48 |
| Total Medicare Payment Amount | 392826.98 |
| Total Medicare Standardized Payment Amount | 387880.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 21960 |
| Number Of Medicare Beneficiaries With Drug Services | 280 |
| Total Drug Submitted ChargeAmount | 23854.5 |
| Total Drug Medicare AllowedAmount | 6442.09 |
| Total Drug Medicare PaymentAmount | 4973.8 |
| Total Drug Medicare Standardized Payment Amount | 4973.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 185 |
| Number Of Medical Services | 6288 |
| Number Of Medicare Beneficiaries With Medical Services | 3766 |
| Total Medical Submitted Charge Amount | 1323583 |
| Total Medical Medicare Allowed Amount | 490787.39 |
| Total Medical Medicare Payment Amount | 387853.18 |
| Total Medical Medicare Standardized Payment Amount | 382906.55 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 689 |
| Number Of Beneficiaries Age 65 to 74 | 1437 |
| Number Of Beneficiaries Age 75 to 84 | 1074 |
| Number Of Beneficiaries Age Greater 84 | 566 |
| Number Of Female Beneficiaries | 2383 |
| Number Of Male Beneficiaries | 1383 |
| Number Of Non Hispanic White Beneficiaries | 3522 |
| Number Of Black or African American Beneficiaries | 157 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2927 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 839 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5092 |