| National Provider Identifier [NPI]: | 1417998253 |
| Last Name Of The Provider | BASH |
| First Name Of The Provider | SUZANNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1516 COTNER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900253303 |
| 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 | 72 |
| Number Of Services | 6707 |
| Number Of Medicare Beneficiaries | 556 |
| Total Submitted Charge Amount | 1241497.39 |
| Total Medicare Allowed Amount | 272151.76 |
| Total Medicare Payment Amount | 211744.94 |
| Total Medicare Standardized Payment Amount | 196241.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5767 |
| Number Of Medicare Beneficiaries With Drug Services | 218 |
| Total Drug Submitted ChargeAmount | 32307.75 |
| Total Drug Medicare AllowedAmount | 5985.62 |
| Total Drug Medicare PaymentAmount | 4615.49 |
| Total Drug Medicare Standardized Payment Amount | 4615.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 556 |
| Total Medical Submitted Charge Amount | 1209189.64 |
| Total Medical Medicare Allowed Amount | 266166.14 |
| Total Medical Medicare Payment Amount | 207129.45 |
| Total Medical Medicare Standardized Payment Amount | 191626.48 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 332 |
| Number Of Male Beneficiaries | 224 |
| Number Of Non Hispanic White Beneficiaries | 487 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 488 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.3802 |