| National Provider Identifier [NPI]: | 1790891596 |
| Last Name Of The Provider | HAZNECI |
| First Name Of The Provider | SINA |
| 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 | 615 FULTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT CLINTON |
| Zip Code Of The Provider | 434522001 |
| 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 | 180 |
| Number Of Services | 8289 |
| Number Of Medicare Beneficiaries | 2542 |
| Total Submitted Charge Amount | 1348153 |
| Total Medicare Allowed Amount | 248308.69 |
| Total Medicare Payment Amount | 183599.56 |
| Total Medicare Standardized Payment Amount | 189284.7 |
| 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 | 180 |
| Number Of Medical Services | 8289 |
| Number Of Medicare Beneficiaries With Medical Services | 2542 |
| Total Medical Submitted Charge Amount | 1348153 |
| Total Medical Medicare Allowed Amount | 248308.69 |
| Total Medical Medicare Payment Amount | 183599.56 |
| Total Medical Medicare Standardized Payment Amount | 189284.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 350 |
| Number Of Beneficiaries Age 65 to 74 | 1039 |
| Number Of Beneficiaries Age 75 to 84 | 760 |
| Number Of Beneficiaries Age Greater 84 | 393 |
| Number Of Female Beneficiaries | 1493 |
| Number Of Male Beneficiaries | 1049 |
| Number Of Non Hispanic White Beneficiaries | 2424 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 432 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1657 |