| National Provider Identifier [NPI]: | 1104032697 |
| Last Name Of The Provider | WAHBA |
| First Name Of The Provider | PETER |
| 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 | 1068 W BALTIMORE PIKE |
| Street Address 2 Of The Provider | RIDDLE MEMORIAL HOSPITAL (DEPT OF RADIOLOGY) |
| City Of The Provider | MEDIA |
| Zip Code Of The Provider | 190635104 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 4515 |
| Number Of Medicare Beneficiaries | 2902 |
| Total Submitted Charge Amount | 932081.94 |
| Total Medicare Allowed Amount | 205822.25 |
| Total Medicare Payment Amount | 159389.95 |
| Total Medicare Standardized Payment Amount | 154044.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 387.94 |
| Total Drug Medicare AllowedAmount | 38.32 |
| Total Drug Medicare PaymentAmount | 30.04 |
| Total Drug Medicare Standardized Payment Amount | 30.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 154 |
| Number Of Medical Services | 4421 |
| Number Of Medicare Beneficiaries With Medical Services | 2902 |
| Total Medical Submitted Charge Amount | 931694 |
| Total Medical Medicare Allowed Amount | 205783.93 |
| Total Medical Medicare Payment Amount | 159359.91 |
| Total Medical Medicare Standardized Payment Amount | 154014.57 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 288 |
| Number Of Beneficiaries Age 65 to 74 | 1025 |
| Number Of Beneficiaries Age 75 to 84 | 871 |
| Number Of Beneficiaries Age Greater 84 | 718 |
| Number Of Female Beneficiaries | 1757 |
| Number Of Male Beneficiaries | 1145 |
| Number Of Non Hispanic White Beneficiaries | 2627 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 477 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.6714 |