| National Provider Identifier [NPI]: | 1659452894 |
| Last Name Of The Provider | HUSSAIN |
| First Name Of The Provider | HERO |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | B1 FLOOR UNIVERSITY HOSPITAL RECP C |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095030 |
| 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 | 33 |
| Number Of Services | 1105 |
| Number Of Medicare Beneficiaries | 810 |
| Total Submitted Charge Amount | 522014 |
| Total Medicare Allowed Amount | 99683.89 |
| Total Medicare Payment Amount | 74798.44 |
| Total Medicare Standardized Payment Amount | 73908.3 |
| 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 | 33 |
| Number Of Medical Services | 1105 |
| Number Of Medicare Beneficiaries With Medical Services | 810 |
| Total Medical Submitted Charge Amount | 522014 |
| Total Medical Medicare Allowed Amount | 99683.89 |
| Total Medical Medicare Payment Amount | 74798.44 |
| Total Medical Medicare Standardized Payment Amount | 73908.3 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 357 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 384 |
| Number Of Male Beneficiaries | 426 |
| Number Of Non Hispanic White Beneficiaries | 670 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 200 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8319 |