| National Provider Identifier [NPI]: | 1659324275 |
| Last Name Of The Provider | AIDEYAN |
| First Name Of The Provider | OSARUGUE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 59TH ST WEST |
| Street Address 2 Of The Provider | BLAKE MEDICAL CENTER |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 34209 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 3308 |
| Number Of Medicare Beneficiaries | 1509 |
| Total Submitted Charge Amount | 483407 |
| Total Medicare Allowed Amount | 144165.6 |
| Total Medicare Payment Amount | 112415.3 |
| Total Medicare Standardized Payment Amount | 112369.64 |
| 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 | 164 |
| Number Of Medical Services | 3308 |
| Number Of Medicare Beneficiaries With Medical Services | 1509 |
| Total Medical Submitted Charge Amount | 483407 |
| Total Medical Medicare Allowed Amount | 144165.6 |
| Total Medical Medicare Payment Amount | 112415.3 |
| Total Medical Medicare Standardized Payment Amount | 112369.64 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 165 |
| Number Of Beneficiaries Age 65 to 74 | 403 |
| Number Of Beneficiaries Age 75 to 84 | 497 |
| Number Of Beneficiaries Age Greater 84 | 444 |
| Number Of Female Beneficiaries | 837 |
| Number Of Male Beneficiaries | 672 |
| Number Of Non Hispanic White Beneficiaries | 1401 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 304 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9769 |