| National Provider Identifier [NPI]: | 1710180799 |
| Last Name Of The Provider | HAZLETT |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1214 SPRING STREET |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | JEFFERSONVILLE |
| Zip Code Of The Provider | 471303704 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 8987 |
| Number Of Medicare Beneficiaries | 3778 |
| Total Submitted Charge Amount | 880220.5 |
| Total Medicare Allowed Amount | 239654.82 |
| Total Medicare Payment Amount | 188406.68 |
| Total Medicare Standardized Payment Amount | 199226.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1877 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 3177 |
| Total Drug Medicare AllowedAmount | 727.81 |
| Total Drug Medicare PaymentAmount | 557.03 |
| Total Drug Medicare Standardized Payment Amount | 557.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 7110 |
| Number Of Medicare Beneficiaries With Medical Services | 3777 |
| Total Medical Submitted Charge Amount | 877043.5 |
| Total Medical Medicare Allowed Amount | 238927.01 |
| Total Medical Medicare Payment Amount | 187849.65 |
| Total Medical Medicare Standardized Payment Amount | 198669.4 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 852 |
| Number Of Beneficiaries Age 65 to 74 | 1455 |
| Number Of Beneficiaries Age 75 to 84 | 997 |
| Number Of Beneficiaries Age Greater 84 | 474 |
| Number Of Female Beneficiaries | 2564 |
| Number Of Male Beneficiaries | 1214 |
| Number Of Non Hispanic White Beneficiaries | 3499 |
| Number Of Black or African American Beneficiaries | 206 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2704 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1074 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6519 |