| National Provider Identifier [NPI]: | 1083660062 |
| Last Name Of The Provider | OLAZABAL |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4250 HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARIANNA |
| Zip Code Of The Provider | 324461917 |
| 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 | 179 |
| Number Of Services | 7194 |
| Number Of Medicare Beneficiaries | 3022 |
| Total Submitted Charge Amount | 528251.14 |
| Total Medicare Allowed Amount | 176443.19 |
| Total Medicare Payment Amount | 133871 |
| Total Medicare Standardized Payment Amount | 134171.59 |
| 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 | 179 |
| Number Of Medical Services | 7194 |
| Number Of Medicare Beneficiaries With Medical Services | 3022 |
| Total Medical Submitted Charge Amount | 528251.14 |
| Total Medical Medicare Allowed Amount | 176443.19 |
| Total Medical Medicare Payment Amount | 133871 |
| Total Medical Medicare Standardized Payment Amount | 134171.59 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 689 |
| Number Of Beneficiaries Age 65 to 74 | 1136 |
| Number Of Beneficiaries Age 75 to 84 | 800 |
| Number Of Beneficiaries Age Greater 84 | 397 |
| Number Of Female Beneficiaries | 1894 |
| Number Of Male Beneficiaries | 1128 |
| Number Of Non Hispanic White Beneficiaries | 2359 |
| Number Of Black or African American Beneficiaries | 622 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1930 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1092 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3654 |