| National Provider Identifier [NPI]: | 1376536771 |
| Last Name Of The Provider | KEISER |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2142 N COVE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436063895 |
| 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 | 143 |
| Number Of Services | 7580 |
| Number Of Medicare Beneficiaries | 5044 |
| Total Submitted Charge Amount | 580320 |
| Total Medicare Allowed Amount | 184287.26 |
| Total Medicare Payment Amount | 137178.81 |
| Total Medicare Standardized Payment Amount | 141591.73 |
| 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 | 143 |
| Number Of Medical Services | 7580 |
| Number Of Medicare Beneficiaries With Medical Services | 5044 |
| Total Medical Submitted Charge Amount | 580320 |
| Total Medical Medicare Allowed Amount | 184287.26 |
| Total Medical Medicare Payment Amount | 137178.81 |
| Total Medical Medicare Standardized Payment Amount | 141591.73 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1083 |
| Number Of Beneficiaries Age 65 to 74 | 1832 |
| Number Of Beneficiaries Age 75 to 84 | 1362 |
| Number Of Beneficiaries Age Greater 84 | 767 |
| Number Of Female Beneficiaries | 2904 |
| Number Of Male Beneficiaries | 2140 |
| Number Of Non Hispanic White Beneficiaries | 4145 |
| Number Of Black or African American Beneficiaries | 660 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 133 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3778 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1266 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7493 |