| National Provider Identifier [NPI]: | 1740446814 |
| Last Name Of The Provider | EGBERT |
| First Name Of The Provider | NATHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2200 JEFFERSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436047101 |
| 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 | 196 |
| Number Of Services | 6865 |
| Number Of Medicare Beneficiaries | 3778 |
| Total Submitted Charge Amount | 692431 |
| Total Medicare Allowed Amount | 189222.01 |
| Total Medicare Payment Amount | 146355.7 |
| Total Medicare Standardized Payment Amount | 150684.36 |
| 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 | 196 |
| Number Of Medical Services | 6865 |
| Number Of Medicare Beneficiaries With Medical Services | 3778 |
| Total Medical Submitted Charge Amount | 692431 |
| Total Medical Medicare Allowed Amount | 189222.01 |
| Total Medical Medicare Payment Amount | 146355.7 |
| Total Medical Medicare Standardized Payment Amount | 150684.36 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 706 |
| Number Of Beneficiaries Age 65 to 74 | 1448 |
| Number Of Beneficiaries Age 75 to 84 | 1136 |
| Number Of Beneficiaries Age Greater 84 | 488 |
| Number Of Female Beneficiaries | 2384 |
| Number Of Male Beneficiaries | 1394 |
| Number Of Non Hispanic White Beneficiaries | 3461 |
| Number Of Black or African American Beneficiaries | 132 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 141 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2836 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 942 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4465 |