| National Provider Identifier [NPI]: | 1962401182 |
| Last Name Of The Provider | SCHULTZ |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 BELLEFONTAINE AVENUE |
| Street Address 2 Of The Provider | LIMA MEMORIAL HEALTH SYSTEM |
| City Of The Provider | LIMA |
| Zip Code Of The Provider | 458042800 |
| 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 | 122 |
| Number Of Services | 5968 |
| Number Of Medicare Beneficiaries | 3971 |
| Total Submitted Charge Amount | 484278 |
| Total Medicare Allowed Amount | 137803.94 |
| Total Medicare Payment Amount | 103872.34 |
| Total Medicare Standardized Payment Amount | 106124.13 |
| 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 | 122 |
| Number Of Medical Services | 5968 |
| Number Of Medicare Beneficiaries With Medical Services | 3971 |
| Total Medical Submitted Charge Amount | 484278 |
| Total Medical Medicare Allowed Amount | 137803.94 |
| Total Medical Medicare Payment Amount | 103872.34 |
| Total Medical Medicare Standardized Payment Amount | 106124.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 827 |
| Number Of Beneficiaries Age 65 to 74 | 1328 |
| Number Of Beneficiaries Age 75 to 84 | 1159 |
| Number Of Beneficiaries Age Greater 84 | 657 |
| Number Of Female Beneficiaries | 2283 |
| Number Of Male Beneficiaries | 1688 |
| Number Of Non Hispanic White Beneficiaries | 3550 |
| Number Of Black or African American Beneficiaries | 321 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2628 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1343 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.695 |