| National Provider Identifier [NPI]: | 1134330954 |
| Last Name Of The Provider | THAKER |
| First Name Of The Provider | HEMA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 S BRYN MAWR AVE |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | BRYN MAWR |
| Zip Code Of The Provider | 190103121 |
| 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 | 175 |
| Number Of Services | 5367 |
| Number Of Medicare Beneficiaries | 3445 |
| Total Submitted Charge Amount | 1581711.41 |
| Total Medicare Allowed Amount | 425195.27 |
| Total Medicare Payment Amount | 328409.46 |
| Total Medicare Standardized Payment Amount | 322659.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 316 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1325.41 |
| Total Drug Medicare AllowedAmount | 129.19 |
| Total Drug Medicare PaymentAmount | 101.26 |
| Total Drug Medicare Standardized Payment Amount | 101.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 174 |
| Number Of Medical Services | 5051 |
| Number Of Medicare Beneficiaries With Medical Services | 3445 |
| Total Medical Submitted Charge Amount | 1580386 |
| Total Medical Medicare Allowed Amount | 425066.08 |
| Total Medical Medicare Payment Amount | 328308.2 |
| Total Medical Medicare Standardized Payment Amount | 322558.49 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 303 |
| Number Of Beneficiaries Age 65 to 74 | 1137 |
| Number Of Beneficiaries Age 75 to 84 | 1135 |
| Number Of Beneficiaries Age Greater 84 | 870 |
| Number Of Female Beneficiaries | 2034 |
| Number Of Male Beneficiaries | 1411 |
| Number Of Non Hispanic White Beneficiaries | 2919 |
| Number Of Black or African American Beneficiaries | 424 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2962 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 483 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9114 |