| National Provider Identifier [NPI]: | 1114930476 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2050 KENNY RD |
| Street Address 2 Of The Provider | SUITE 2200 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432213502 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1011 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 219569 |
| Total Medicare Allowed Amount | 93573.16 |
| Total Medicare Payment Amount | 70426.58 |
| Total Medicare Standardized Payment Amount | 73849.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 6339 |
| Total Drug Medicare AllowedAmount | 2796.23 |
| Total Drug Medicare PaymentAmount | 2272.91 |
| Total Drug Medicare Standardized Payment Amount | 2272.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 885 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 213230 |
| Total Medical Medicare Allowed Amount | 90776.93 |
| Total Medical Medicare Payment Amount | 68153.67 |
| Total Medical Medicare Standardized Payment Amount | 71576.39 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 170 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 363 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 297 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 69 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.3438 |