| National Provider Identifier [NPI]: | 1497788756 |
| Last Name Of The Provider | DEBAZ |
| First Name Of The Provider | BAZ |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13207 RAVENNA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARDON |
| Zip Code Of The Provider | 440247032 |
| 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 | 139 |
| Number Of Services | 3789 |
| Number Of Medicare Beneficiaries | 2351 |
| Total Submitted Charge Amount | 340781 |
| Total Medicare Allowed Amount | 114463.64 |
| Total Medicare Payment Amount | 87663.86 |
| Total Medicare Standardized Payment Amount | 89713.89 |
| 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 | 139 |
| Number Of Medical Services | 3789 |
| Number Of Medicare Beneficiaries With Medical Services | 2351 |
| Total Medical Submitted Charge Amount | 340781 |
| Total Medical Medicare Allowed Amount | 114463.64 |
| Total Medical Medicare Payment Amount | 87663.86 |
| Total Medical Medicare Standardized Payment Amount | 89713.89 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 359 |
| Number Of Beneficiaries Age 65 to 74 | 815 |
| Number Of Beneficiaries Age 75 to 84 | 707 |
| Number Of Beneficiaries Age Greater 84 | 470 |
| Number Of Female Beneficiaries | 1527 |
| Number Of Male Beneficiaries | 824 |
| Number Of Non Hispanic White Beneficiaries | 1683 |
| Number Of Black or African American Beneficiaries | 596 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1759 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 592 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8143 |