| National Provider Identifier [NPI]: | 1053527408 |
| Last Name Of The Provider | STAVA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10500 MONTGOMERY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452424402 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 4690 |
| Number Of Medicare Beneficiaries | 3218 |
| Total Submitted Charge Amount | 553340.75 |
| Total Medicare Allowed Amount | 164877.11 |
| Total Medicare Payment Amount | 127552.64 |
| Total Medicare Standardized Payment Amount | 131610.72 |
| 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 | 178 |
| Number Of Medical Services | 4690 |
| Number Of Medicare Beneficiaries With Medical Services | 3218 |
| Total Medical Submitted Charge Amount | 553340.75 |
| Total Medical Medicare Allowed Amount | 164877.11 |
| Total Medical Medicare Payment Amount | 127552.64 |
| Total Medical Medicare Standardized Payment Amount | 131610.72 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 420 |
| Number Of Beneficiaries Age 65 to 74 | 1275 |
| Number Of Beneficiaries Age 75 to 84 | 930 |
| Number Of Beneficiaries Age Greater 84 | 593 |
| Number Of Female Beneficiaries | 1903 |
| Number Of Male Beneficiaries | 1315 |
| Number Of Non Hispanic White Beneficiaries | 2942 |
| Number Of Black or African American Beneficiaries | 175 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2659 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 559 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6268 |