| National Provider Identifier [NPI]: | 1295751394 |
| Last Name Of The Provider | SKILLICORN |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9825 KENWOOD RD |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | BLUE ASH |
| Zip Code Of The Provider | 452426251 |
| 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 | 172 |
| Number Of Services | 3696 |
| Number Of Medicare Beneficiaries | 2694 |
| Total Submitted Charge Amount | 467433 |
| Total Medicare Allowed Amount | 143590.14 |
| Total Medicare Payment Amount | 107162.87 |
| Total Medicare Standardized Payment Amount | 110607.3 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 524 |
| Number Of Beneficiaries Age 65 to 74 | 925 |
| Number Of Beneficiaries Age 75 to 84 | 771 |
| Number Of Beneficiaries Age Greater 84 | 474 |
| Number Of Female Beneficiaries | 1583 |
| Number Of Male Beneficiaries | 1111 |
| Number Of Non Hispanic White Beneficiaries | 2156 |
| Number Of Black or African American Beneficiaries | 458 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2064 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 630 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0498 |