| National Provider Identifier [NPI]: | 1023026945 |
| Last Name Of The Provider | HAZLETT |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 W COCOA BEACH CSWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | COCOA BEACH |
| Zip Code Of The Provider | 329313585 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 220 |
| Number Of Services | 6389 |
| Number Of Medicare Beneficiaries | 4035 |
| Total Submitted Charge Amount | 599344 |
| Total Medicare Allowed Amount | 203026.48 |
| Total Medicare Payment Amount | 154579.09 |
| Total Medicare Standardized Payment Amount | 155844.39 |
| 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 | 220 |
| Number Of Medical Services | 6389 |
| Number Of Medicare Beneficiaries With Medical Services | 4035 |
| Total Medical Submitted Charge Amount | 599344 |
| Total Medical Medicare Allowed Amount | 203026.48 |
| Total Medical Medicare Payment Amount | 154579.09 |
| Total Medical Medicare Standardized Payment Amount | 155844.39 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 510 |
| Number Of Beneficiaries Age 65 to 74 | 1348 |
| Number Of Beneficiaries Age 75 to 84 | 1338 |
| Number Of Beneficiaries Age Greater 84 | 839 |
| Number Of Female Beneficiaries | 2427 |
| Number Of Male Beneficiaries | 1608 |
| Number Of Non Hispanic White Beneficiaries | 3576 |
| Number Of Black or African American Beneficiaries | 247 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 135 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3417 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 618 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7129 |