| National Provider Identifier [NPI]: | 1194823690 |
| Last Name Of The Provider | MAZZEI |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 E ANTIETAM ST |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | HAGERSTOWN |
| Zip Code Of The Provider | 217405794 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 13849 |
| Number Of Medicare Beneficiaries | 2775 |
| Total Submitted Charge Amount | 855419.1 |
| Total Medicare Allowed Amount | 330526.88 |
| Total Medicare Payment Amount | 268320.7 |
| Total Medicare Standardized Payment Amount | 266172.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 9010 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 10215.1 |
| Total Drug Medicare AllowedAmount | 2663.73 |
| Total Drug Medicare PaymentAmount | 2054.47 |
| Total Drug Medicare Standardized Payment Amount | 2054.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 4839 |
| Number Of Medicare Beneficiaries With Medical Services | 2775 |
| Total Medical Submitted Charge Amount | 845204 |
| Total Medical Medicare Allowed Amount | 327863.15 |
| Total Medical Medicare Payment Amount | 266266.23 |
| Total Medical Medicare Standardized Payment Amount | 264117.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 541 |
| Number Of Beneficiaries Age 65 to 74 | 997 |
| Number Of Beneficiaries Age 75 to 84 | 824 |
| Number Of Beneficiaries Age Greater 84 | 413 |
| Number Of Female Beneficiaries | 1813 |
| Number Of Male Beneficiaries | 962 |
| Number Of Non Hispanic White Beneficiaries | 2608 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2091 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 684 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6286 |