| National Provider Identifier [NPI]: | 1992704381 |
| Last Name Of The Provider | BECKETT |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 326 W 64TH ST |
| Street Address 2 Of The Provider | ST BERNARD HOSPITAL DEPT RADIOLOGY |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606213114 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 4190 |
| Number Of Medicare Beneficiaries | 1296 |
| Total Submitted Charge Amount | 399477 |
| Total Medicare Allowed Amount | 114904.18 |
| Total Medicare Payment Amount | 89316.76 |
| Total Medicare Standardized Payment Amount | 83403.43 |
| 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 | 118 |
| Number Of Medical Services | 4190 |
| Number Of Medicare Beneficiaries With Medical Services | 1296 |
| Total Medical Submitted Charge Amount | 399477 |
| Total Medical Medicare Allowed Amount | 114904.18 |
| Total Medical Medicare Payment Amount | 89316.76 |
| Total Medical Medicare Standardized Payment Amount | 83403.43 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 442 |
| Number Of Beneficiaries Age 65 to 74 | 380 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 786 |
| Number Of Male Beneficiaries | 510 |
| Number Of Non Hispanic White Beneficiaries | 35 |
| Number Of Black or African American Beneficiaries | 1230 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 441 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 855 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 27 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.2421 |