| National Provider Identifier [NPI]: | 1417967118 |
| Last Name Of The Provider | AZEM |
| First Name Of The Provider | HAITHAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 88 CENTER RD STE 130 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 441462708 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 12273 |
| Number Of Medicare Beneficiaries | 1169 |
| Total Submitted Charge Amount | 1296152 |
| Total Medicare Allowed Amount | 911425.79 |
| Total Medicare Payment Amount | 675519.76 |
| Total Medicare Standardized Payment Amount | 696061.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 4282 |
| Total Drug Medicare AllowedAmount | 1906.48 |
| Total Drug Medicare PaymentAmount | 1739.63 |
| Total Drug Medicare Standardized Payment Amount | 1739.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 12114 |
| Number Of Medicare Beneficiaries With Medical Services | 1169 |
| Total Medical Submitted Charge Amount | 1291870 |
| Total Medical Medicare Allowed Amount | 909519.31 |
| Total Medical Medicare Payment Amount | 673780.13 |
| Total Medical Medicare Standardized Payment Amount | 694322.31 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 311 |
| Number Of Beneficiaries Age Greater 84 | 425 |
| Number Of Female Beneficiaries | 746 |
| Number Of Male Beneficiaries | 423 |
| Number Of Non Hispanic White Beneficiaries | 778 |
| Number Of Black or African American Beneficiaries | 368 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 649 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 520 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 49 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.1707 |