| National Provider Identifier [NPI]: | 1760568745 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | TERRENCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 ARLINGTON AVENUE |
| Street Address 2 Of The Provider | MS1200 |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436142929 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 4481 |
| Number Of Medicare Beneficiaries | 2290 |
| Total Submitted Charge Amount | 396731.52 |
| Total Medicare Allowed Amount | 125482.01 |
| Total Medicare Payment Amount | 96195.69 |
| Total Medicare Standardized Payment Amount | 98808.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 200 |
| Number Of Medical Services | 4481 |
| Number Of Medicare Beneficiaries With Medical Services | 2290 |
| Total Medical Submitted Charge Amount | 396731.52 |
| Total Medical Medicare Allowed Amount | 125482.01 |
| Total Medical Medicare Payment Amount | 96195.69 |
| Total Medical Medicare Standardized Payment Amount | 98808.71 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 815 |
| Number Of Beneficiaries Age 65 to 74 | 738 |
| Number Of Beneficiaries Age 75 to 84 | 507 |
| Number Of Beneficiaries Age Greater 84 | 230 |
| Number Of Female Beneficiaries | 1325 |
| Number Of Male Beneficiaries | 965 |
| Number Of Non Hispanic White Beneficiaries | 1698 |
| Number Of Black or African American Beneficiaries | 474 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1017 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1123 |