| National Provider Identifier [NPI]: | 1184689143 |
| Last Name Of The Provider | MOHTADI |
| First Name Of The Provider | NADER |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5333 MCAULEY DR |
| Street Address 2 Of The Provider | SUITE 6016 |
| City Of The Provider | YPSILANTI |
| Zip Code Of The Provider | 481971014 |
| 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 | 148 |
| Number Of Services | 5219 |
| Number Of Medicare Beneficiaries | 3743 |
| Total Submitted Charge Amount | 511618 |
| Total Medicare Allowed Amount | 177012.16 |
| Total Medicare Payment Amount | 132189.26 |
| Total Medicare Standardized Payment Amount | 130063.69 |
| 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 | 148 |
| Number Of Medical Services | 5219 |
| Number Of Medicare Beneficiaries With Medical Services | 3743 |
| Total Medical Submitted Charge Amount | 511618 |
| Total Medical Medicare Allowed Amount | 177012.16 |
| Total Medical Medicare Payment Amount | 132189.26 |
| Total Medical Medicare Standardized Payment Amount | 130063.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 638 |
| Number Of Beneficiaries Age 65 to 74 | 1145 |
| Number Of Beneficiaries Age 75 to 84 | 1072 |
| Number Of Beneficiaries Age Greater 84 | 888 |
| Number Of Female Beneficiaries | 2268 |
| Number Of Male Beneficiaries | 1475 |
| Number Of Non Hispanic White Beneficiaries | 3267 |
| Number Of Black or African American Beneficiaries | 326 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2953 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 790 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9423 |