| National Provider Identifier [NPI]: | 1720078629 |
| Last Name Of The Provider | YOUSSEF |
| First Name Of The Provider | HISHAM |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD RADIOLOGIST |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 112 E CLARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISBURG |
| Zip Code Of The Provider | 629462703 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 235 |
| Number Of Services | 27278 |
| Number Of Medicare Beneficiaries | 7724 |
| Total Submitted Charge Amount | 5505038.25 |
| Total Medicare Allowed Amount | 905284.66 |
| Total Medicare Payment Amount | 682464.76 |
| Total Medicare Standardized Payment Amount | 705980.42 |
| 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 | 235 |
| Number Of Medical Services | 27278 |
| Number Of Medicare Beneficiaries With Medical Services | 7724 |
| Total Medical Submitted Charge Amount | 5505038.25 |
| Total Medical Medicare Allowed Amount | 905284.66 |
| Total Medical Medicare Payment Amount | 682464.76 |
| Total Medical Medicare Standardized Payment Amount | 705980.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1493 |
| Number Of Beneficiaries Age 65 to 74 | 3048 |
| Number Of Beneficiaries Age 75 to 84 | 2231 |
| Number Of Beneficiaries Age Greater 84 | 952 |
| Number Of Female Beneficiaries | 4821 |
| Number Of Male Beneficiaries | 2903 |
| Number Of Non Hispanic White Beneficiaries | 7529 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5423 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2301 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1533 |