| National Provider Identifier [NPI]: | 1013004068 |
| Last Name Of The Provider | HARNSBERGER |
| First Name Of The Provider | HUGH |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 N MEDICAL DR |
| Street Address 2 Of The Provider | 1A71 |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841320001 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 532 |
| Number Of Medicare Beneficiaries | 368 |
| Total Submitted Charge Amount | 126766.14 |
| Total Medicare Allowed Amount | 33159.41 |
| Total Medicare Payment Amount | 24059.24 |
| Total Medicare Standardized Payment Amount | 25337.37 |
| 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 | 33 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 368 |
| Total Medical Submitted Charge Amount | 126766.14 |
| Total Medical Medicare Allowed Amount | 33159.41 |
| Total Medical Medicare Payment Amount | 24059.24 |
| Total Medical Medicare Standardized Payment Amount | 25337.37 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 312 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 1.6131 |