| National Provider Identifier [NPI]: | 1992797005 |
| Last Name Of The Provider | STOUT |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 221 W 8TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LORAIN |
| Zip Code Of The Provider | 440521817 |
| 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 | 229 |
| Number Of Services | 6550 |
| Number Of Medicare Beneficiaries | 3288 |
| Total Submitted Charge Amount | 741130 |
| Total Medicare Allowed Amount | 231382.77 |
| Total Medicare Payment Amount | 176663.66 |
| Total Medicare Standardized Payment Amount | 181478.78 |
| 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 | 229 |
| Number Of Medical Services | 6550 |
| Number Of Medicare Beneficiaries With Medical Services | 3288 |
| Total Medical Submitted Charge Amount | 741130 |
| Total Medical Medicare Allowed Amount | 231382.77 |
| Total Medical Medicare Payment Amount | 176663.66 |
| Total Medical Medicare Standardized Payment Amount | 181478.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 721 |
| Number Of Beneficiaries Age 65 to 74 | 1041 |
| Number Of Beneficiaries Age 75 to 84 | 970 |
| Number Of Beneficiaries Age Greater 84 | 556 |
| Number Of Female Beneficiaries | 1913 |
| Number Of Male Beneficiaries | 1375 |
| Number Of Non Hispanic White Beneficiaries | 2749 |
| Number Of Black or African American Beneficiaries | 323 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 176 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2374 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 914 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0316 |