| National Provider Identifier [NPI]: | 1528221983 |
| Last Name Of The Provider | AZAB |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 723 PALISADES BEACH RD |
| Street Address 2 Of The Provider | APT 214 |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904022621 |
| 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 | 117 |
| Number Of Services | 5257 |
| Number Of Medicare Beneficiaries | 1436 |
| Total Submitted Charge Amount | 439646.72 |
| Total Medicare Allowed Amount | 91879.99 |
| Total Medicare Payment Amount | 71666.05 |
| Total Medicare Standardized Payment Amount | 66168.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3009 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 3722.72 |
| Total Drug Medicare AllowedAmount | 882.84 |
| Total Drug Medicare PaymentAmount | 692.21 |
| Total Drug Medicare Standardized Payment Amount | 692.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 2248 |
| Number Of Medicare Beneficiaries With Medical Services | 1436 |
| Total Medical Submitted Charge Amount | 435924 |
| Total Medical Medicare Allowed Amount | 90997.15 |
| Total Medical Medicare Payment Amount | 70973.84 |
| Total Medical Medicare Standardized Payment Amount | 65476.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 262 |
| Number Of Beneficiaries Age 65 to 74 | 456 |
| Number Of Beneficiaries Age 75 to 84 | 431 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 842 |
| Number Of Male Beneficiaries | 594 |
| Number Of Non Hispanic White Beneficiaries | 752 |
| Number Of Black or African American Beneficiaries | 165 |
| Number Of AsianPacific Islander Beneficiaries | 184 |
| Number Of Hispanic Beneficiaries | 295 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 556 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 880 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3442 |