| National Provider Identifier [NPI]: | 1578646808 |
| Last Name Of The Provider | LAZO |
| First Name Of The Provider | FAUSTO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55741 NATIONAL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRIDGEPORT |
| Zip Code Of The Provider | 43912 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 1791 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 152707 |
| Total Medicare Allowed Amount | 89484.16 |
| Total Medicare Payment Amount | 66761.82 |
| Total Medicare Standardized Payment Amount | 70427.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 390 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 6997 |
| Total Drug Medicare AllowedAmount | 2543.45 |
| Total Drug Medicare PaymentAmount | 2333.12 |
| Total Drug Medicare Standardized Payment Amount | 2333.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1401 |
| Number Of Medicare Beneficiaries With Medical Services | 243 |
| Total Medical Submitted Charge Amount | 145710 |
| Total Medical Medicare Allowed Amount | 86940.71 |
| Total Medical Medicare Payment Amount | 64428.7 |
| Total Medical Medicare Standardized Payment Amount | 68094.7 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 112 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0527 |