| National Provider Identifier [NPI]: | 1073557518 |
| Last Name Of The Provider | KLIOZE |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 MASON AVE |
| Street Address 2 Of The Provider | SUITE # 305 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175515 |
| 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 | 280 |
| Number Of Services | 23661.5 |
| Number Of Medicare Beneficiaries | 1806 |
| Total Submitted Charge Amount | 930132.09 |
| Total Medicare Allowed Amount | 274076.03 |
| Total Medicare Payment Amount | 206551.91 |
| Total Medicare Standardized Payment Amount | 211331.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 21006.5 |
| Number Of Medicare Beneficiaries With Drug Services | 259 |
| Total Drug Submitted ChargeAmount | 29605.82 |
| Total Drug Medicare AllowedAmount | 4566.23 |
| Total Drug Medicare PaymentAmount | 3562.96 |
| Total Drug Medicare Standardized Payment Amount | 3562.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 271 |
| Number Of Medical Services | 2655 |
| Number Of Medicare Beneficiaries With Medical Services | 1801 |
| Total Medical Submitted Charge Amount | 900526.27 |
| Total Medical Medicare Allowed Amount | 269509.8 |
| Total Medical Medicare Payment Amount | 202988.95 |
| Total Medical Medicare Standardized Payment Amount | 207768.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 322 |
| Number Of Beneficiaries Age 65 to 74 | 669 |
| Number Of Beneficiaries Age 75 to 84 | 543 |
| Number Of Beneficiaries Age Greater 84 | 272 |
| Number Of Female Beneficiaries | 1006 |
| Number Of Male Beneficiaries | 800 |
| Number Of Non Hispanic White Beneficiaries | 1593 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1403 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 403 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6687 |