| National Provider Identifier [NPI]: | 1275552952 |
| Last Name Of The Provider | MALL |
| First Name Of The Provider | SHARAL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 540 LINCOLN PARK BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | KETTERING |
| Zip Code Of The Provider | 454296401 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 4893 |
| Number Of Medicare Beneficiaries | 2832 |
| Total Submitted Charge Amount | 453567 |
| Total Medicare Allowed Amount | 119365.64 |
| Total Medicare Payment Amount | 89702.59 |
| Total Medicare Standardized Payment Amount | 92278.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1200 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 336 |
| Total Drug Medicare AllowedAmount | 241.2 |
| Total Drug Medicare PaymentAmount | 170.51 |
| Total Drug Medicare Standardized Payment Amount | 170.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 152 |
| Number Of Medical Services | 3693 |
| Number Of Medicare Beneficiaries With Medical Services | 2832 |
| Total Medical Submitted Charge Amount | 453231 |
| Total Medical Medicare Allowed Amount | 119124.44 |
| Total Medical Medicare Payment Amount | 89532.08 |
| Total Medical Medicare Standardized Payment Amount | 92107.77 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 612 |
| Number Of Beneficiaries Age 65 to 74 | 1041 |
| Number Of Beneficiaries Age 75 to 84 | 745 |
| Number Of Beneficiaries Age Greater 84 | 434 |
| Number Of Female Beneficiaries | 1759 |
| Number Of Male Beneficiaries | 1073 |
| Number Of Non Hispanic White Beneficiaries | 2556 |
| Number Of Black or African American Beneficiaries | 199 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 729 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| 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 | 1.7173 |