| National Provider Identifier [NPI]: | 1043311244 |
| Last Name Of The Provider | OH |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2800 E AJO WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857136204 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 11115 |
| Number Of Medicare Beneficiaries | 3314 |
| Total Submitted Charge Amount | 3737167.65 |
| Total Medicare Allowed Amount | 592848.28 |
| Total Medicare Payment Amount | 438618.18 |
| Total Medicare Standardized Payment Amount | 396288.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6685 |
| Number Of Medicare Beneficiaries With Drug Services | 278 |
| Total Drug Submitted ChargeAmount | 11820.65 |
| Total Drug Medicare AllowedAmount | 5625.1 |
| Total Drug Medicare PaymentAmount | 4397.19 |
| Total Drug Medicare Standardized Payment Amount | 4397.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 4430 |
| Number Of Medicare Beneficiaries With Medical Services | 3314 |
| Total Medical Submitted Charge Amount | 3725347 |
| Total Medical Medicare Allowed Amount | 587223.18 |
| Total Medical Medicare Payment Amount | 434220.99 |
| Total Medical Medicare Standardized Payment Amount | 391890.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 421 |
| Number Of Beneficiaries Age 65 to 74 | 1245 |
| Number Of Beneficiaries Age 75 to 84 | 1127 |
| Number Of Beneficiaries Age Greater 84 | 521 |
| Number Of Female Beneficiaries | 2067 |
| Number Of Male Beneficiaries | 1247 |
| Number Of Non Hispanic White Beneficiaries | 1059 |
| Number Of Black or African American Beneficiaries | 295 |
| Number Of AsianPacific Islander Beneficiaries | 1279 |
| Number Of Hispanic Beneficiaries | 590 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 946 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2368 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.018 |