| National Provider Identifier [NPI]: | 1629000302 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | MARCO |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 96 CAMPUS DRIVE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | SCARBOROUGH |
| Zip Code Of The Provider | 04074 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3061 |
| Number Of Medicare Beneficiaries | 1648 |
| Total Submitted Charge Amount | 335393 |
| Total Medicare Allowed Amount | 181054.88 |
| Total Medicare Payment Amount | 137575.04 |
| Total Medicare Standardized Payment Amount | 140154.31 |
| 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 | 67 |
| Number Of Medical Services | 3061 |
| Number Of Medicare Beneficiaries With Medical Services | 1648 |
| Total Medical Submitted Charge Amount | 335393 |
| Total Medical Medicare Allowed Amount | 181054.88 |
| Total Medical Medicare Payment Amount | 137575.04 |
| Total Medical Medicare Standardized Payment Amount | 140154.31 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 239 |
| Number Of Beneficiaries Age 65 to 74 | 516 |
| Number Of Beneficiaries Age 75 to 84 | 558 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 768 |
| Number Of Male Beneficiaries | 880 |
| Number Of Non Hispanic White Beneficiaries | 1595 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1064 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 584 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7849 |