| National Provider Identifier [NPI]: | 1093884629 |
| Last Name Of The Provider | OLAZAGASTI |
| First Name Of The Provider | JUAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LEE ST FL 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 17973 |
| Number Of Medicare Beneficiaries | 3304 |
| Total Submitted Charge Amount | 1371274.28 |
| Total Medicare Allowed Amount | 163927.15 |
| Total Medicare Payment Amount | 120399.23 |
| Total Medicare Standardized Payment Amount | 128185.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12097 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 15438.28 |
| Total Drug Medicare AllowedAmount | 2312.34 |
| Total Drug Medicare PaymentAmount | 1770.09 |
| Total Drug Medicare Standardized Payment Amount | 1770.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 5876 |
| Number Of Medicare Beneficiaries With Medical Services | 3304 |
| Total Medical Submitted Charge Amount | 1355836 |
| Total Medical Medicare Allowed Amount | 161614.81 |
| Total Medical Medicare Payment Amount | 118629.14 |
| Total Medical Medicare Standardized Payment Amount | 126415.69 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 758 |
| Number Of Beneficiaries Age 65 to 74 | 1284 |
| Number Of Beneficiaries Age 75 to 84 | 880 |
| Number Of Beneficiaries Age Greater 84 | 382 |
| Number Of Female Beneficiaries | 1670 |
| Number Of Male Beneficiaries | 1634 |
| Number Of Non Hispanic White Beneficiaries | 2700 |
| Number Of Black or African American Beneficiaries | 515 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 885 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0836 |