| National Provider Identifier [NPI]: | 1447236377 |
| Last Name Of The Provider | PEREZ |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 234 GOODMAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452192364 |
| 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 | 149 |
| Number Of Services | 5027 |
| Number Of Medicare Beneficiaries | 2891 |
| Total Submitted Charge Amount | 634685 |
| Total Medicare Allowed Amount | 147447.84 |
| Total Medicare Payment Amount | 109571.67 |
| Total Medicare Standardized Payment Amount | 116705.77 |
| 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 | 149 |
| Number Of Medical Services | 5027 |
| Number Of Medicare Beneficiaries With Medical Services | 2891 |
| Total Medical Submitted Charge Amount | 634685 |
| Total Medical Medicare Allowed Amount | 147447.84 |
| Total Medical Medicare Payment Amount | 109571.67 |
| Total Medical Medicare Standardized Payment Amount | 116705.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 523 |
| Number Of Beneficiaries Age 65 to 74 | 1000 |
| Number Of Beneficiaries Age 75 to 84 | 865 |
| Number Of Beneficiaries Age Greater 84 | 503 |
| Number Of Female Beneficiaries | 1644 |
| Number Of Male Beneficiaries | 1247 |
| Number Of Non Hispanic White Beneficiaries | 2784 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2091 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 800 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7069 |