| National Provider Identifier [NPI]: | 1609938281 |
| Last Name Of The Provider | FAZEKAS |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2201 CHAPEL AVE W |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPT |
| City Of The Provider | CHERRY HILL |
| Zip Code Of The Provider | 080022048 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 6152 |
| Number Of Medicare Beneficiaries | 3366 |
| Total Submitted Charge Amount | 904974 |
| Total Medicare Allowed Amount | 229238.82 |
| Total Medicare Payment Amount | 178310.35 |
| Total Medicare Standardized Payment Amount | 177132.26 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 755 |
| Number Of Beneficiaries Age 65 to 74 | 978 |
| Number Of Beneficiaries Age 75 to 84 | 855 |
| Number Of Beneficiaries Age Greater 84 | 778 |
| Number Of Female Beneficiaries | 1928 |
| Number Of Male Beneficiaries | 1438 |
| Number Of Non Hispanic White Beneficiaries | 2543 |
| Number Of Black or African American Beneficiaries | 606 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 132 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1068 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.2295 |