National Provider Identifier [NPI]: |
1831132992 |
Last Name Of The Provider |
HARRILL |
First Name Of The Provider |
CONNIE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7340 SHADELAND STA |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462563979 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
3549 |
Number Of Medicare Beneficiaries |
2061 |
Total Submitted Charge Amount |
154021 |
Total Medicare Allowed Amount |
65868.79 |
Total Medicare Payment Amount |
56047.19 |
Total Medicare Standardized Payment Amount |
58709.84 |
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 |
87 |
Number Of Medical Services |
3549 |
Number Of Medicare Beneficiaries With Medical Services |
2061 |
Total Medical Submitted Charge Amount |
154021 |
Total Medical Medicare Allowed Amount |
65868.79 |
Total Medical Medicare Payment Amount |
56047.19 |
Total Medical Medicare Standardized Payment Amount |
58709.84 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
289 |
Number Of Beneficiaries Age 65 to 74 |
1029 |
Number Of Beneficiaries Age 75 to 84 |
536 |
Number Of Beneficiaries Age Greater 84 |
207 |
Number Of Female Beneficiaries |
1766 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
1677 |
Number Of Black or African American Beneficiaries |
321 |
Number Of AsianPacific Islander Beneficiaries |
27 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
1747 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
314 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1181 |