| National Provider Identifier [NPI]: | 1316925209 |
| Last Name Of The Provider | HAZLETT |
| First Name Of The Provider | SHAWN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1230 S CEDAR CREST BLVD |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181036367 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 28453 |
| Number Of Medicare Beneficiaries | 951 |
| Total Submitted Charge Amount | 4704830.8 |
| Total Medicare Allowed Amount | 1356546.21 |
| Total Medicare Payment Amount | 1054061.46 |
| Total Medicare Standardized Payment Amount | 1130335.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 24642 |
| Number Of Medicare Beneficiaries With Drug Services | 317 |
| Total Drug Submitted ChargeAmount | 63809.8 |
| Total Drug Medicare AllowedAmount | 7273.7 |
| Total Drug Medicare PaymentAmount | 5677.8 |
| Total Drug Medicare Standardized Payment Amount | 5677.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 3811 |
| Number Of Medicare Beneficiaries With Medical Services | 951 |
| Total Medical Submitted Charge Amount | 4641021 |
| Total Medical Medicare Allowed Amount | 1349272.51 |
| Total Medical Medicare Payment Amount | 1048383.66 |
| Total Medical Medicare Standardized Payment Amount | 1124658.15 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 275 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 540 |
| Number Of Non Hispanic White Beneficiaries | 770 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 675 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 276 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 65 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 5.3959 |