| National Provider Identifier [NPI]: | 1104044130 |
| Last Name Of The Provider | ABEDIN |
| First Name Of The Provider | SAMI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 65 SOCKANOSSET CROSS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRANSTON |
| Zip Code Of The Provider | 029205536 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 6274 |
| Number Of Medicare Beneficiaries | 2531 |
| Total Submitted Charge Amount | 807747.2 |
| Total Medicare Allowed Amount | 177267.62 |
| Total Medicare Payment Amount | 138187.06 |
| Total Medicare Standardized Payment Amount | 135536.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2436 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 2785.2 |
| Total Drug Medicare AllowedAmount | 798.69 |
| Total Drug Medicare PaymentAmount | 601.12 |
| Total Drug Medicare Standardized Payment Amount | 601.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 3838 |
| Number Of Medicare Beneficiaries With Medical Services | 2531 |
| Total Medical Submitted Charge Amount | 804962 |
| Total Medical Medicare Allowed Amount | 176468.93 |
| Total Medical Medicare Payment Amount | 137585.94 |
| Total Medical Medicare Standardized Payment Amount | 134934.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 540 |
| Number Of Beneficiaries Age 65 to 74 | 899 |
| Number Of Beneficiaries Age 75 to 84 | 588 |
| Number Of Beneficiaries Age Greater 84 | 504 |
| Number Of Female Beneficiaries | 1609 |
| Number Of Male Beneficiaries | 922 |
| Number Of Non Hispanic White Beneficiaries | 2293 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1794 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 737 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5772 |