| National Provider Identifier [NPI]: | 1396789269 |
| Last Name Of The Provider | HAZLEWOOD |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 PHYSICIANS WAY |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 370908102 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 847 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 86891.45 |
| Total Medicare Allowed Amount | 56808.56 |
| Total Medicare Payment Amount | 42391.48 |
| Total Medicare Standardized Payment Amount | 44341.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 256 |
| Total Drug Medicare AllowedAmount | 66.91 |
| Total Drug Medicare PaymentAmount | 49.78 |
| Total Drug Medicare Standardized Payment Amount | 49.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 814 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 86635.45 |
| Total Medical Medicare Allowed Amount | 56741.65 |
| Total Medical Medicare Payment Amount | 42341.7 |
| Total Medical Medicare Standardized Payment Amount | 44292.05 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| 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 | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3586 |