| National Provider Identifier [NPI]: | 1114976727 |
| Last Name Of The Provider | SZYMANOWSKI |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24451 HEALTH CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAGUNA HILLS |
| Zip Code Of The Provider | 926533689 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 3307 |
| Number Of Medicare Beneficiaries | 2161 |
| Total Submitted Charge Amount | 469721 |
| Total Medicare Allowed Amount | 125312.98 |
| Total Medicare Payment Amount | 93986.6 |
| Total Medicare Standardized Payment Amount | 88707.81 |
| 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 | 161 |
| Number Of Medical Services | 3307 |
| Number Of Medicare Beneficiaries With Medical Services | 2161 |
| Total Medical Submitted Charge Amount | 469721 |
| Total Medical Medicare Allowed Amount | 125312.98 |
| Total Medical Medicare Payment Amount | 93986.6 |
| Total Medical Medicare Standardized Payment Amount | 88707.81 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 676 |
| Number Of Beneficiaries Age 75 to 84 | 707 |
| Number Of Beneficiaries Age Greater 84 | 623 |
| Number Of Female Beneficiaries | 1272 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 1590 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | 362 |
| Number Of Hispanic Beneficiaries | 133 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1611 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 550 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9442 |