| National Provider Identifier [NPI]: | 1275508939 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3401 SPRINGHILL DR |
| Street Address 2 Of The Provider | SUITE345 |
| City Of The Provider | NORTH LITTLE ROCK |
| Zip Code Of The Provider | 721172924 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 39786 |
| Number Of Medicare Beneficiaries | 1693 |
| Total Submitted Charge Amount | 2950534.2 |
| Total Medicare Allowed Amount | 1220135.48 |
| Total Medicare Payment Amount | 950704.54 |
| Total Medicare Standardized Payment Amount | 1023393.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 23624 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 447057.7 |
| Total Drug Medicare AllowedAmount | 339491.93 |
| Total Drug Medicare PaymentAmount | 265771 |
| Total Drug Medicare Standardized Payment Amount | 265771 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 16162 |
| Number Of Medicare Beneficiaries With Medical Services | 1693 |
| Total Medical Submitted Charge Amount | 2503476.5 |
| Total Medical Medicare Allowed Amount | 880643.55 |
| Total Medical Medicare Payment Amount | 684933.54 |
| Total Medical Medicare Standardized Payment Amount | 757622.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 813 |
| Number Of Beneficiaries Age 75 to 84 | 542 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 570 |
| Number Of Male Beneficiaries | 1123 |
| Number Of Non Hispanic White Beneficiaries | 1508 |
| Number Of Black or African American Beneficiaries | 151 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1499 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 194 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1918 |