National Provider Identifier [NPI]: |
1730268590 |
Last Name Of The Provider |
MORESCO |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 HAMILTON BLVD |
Street Address 2 Of The Provider |
1824 |
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616021144 |
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 |
204 |
Number Of Services |
2862 |
Number Of Medicare Beneficiaries |
1668 |
Total Submitted Charge Amount |
1347699 |
Total Medicare Allowed Amount |
196767.72 |
Total Medicare Payment Amount |
151192.78 |
Total Medicare Standardized Payment Amount |
151898.09 |
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 |
204 |
Number Of Medical Services |
2862 |
Number Of Medicare Beneficiaries With Medical Services |
1668 |
Total Medical Submitted Charge Amount |
1347699 |
Total Medical Medicare Allowed Amount |
196767.72 |
Total Medical Medicare Payment Amount |
151192.78 |
Total Medical Medicare Standardized Payment Amount |
151898.09 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
277 |
Number Of Beneficiaries Age 65 to 74 |
647 |
Number Of Beneficiaries Age 75 to 84 |
501 |
Number Of Beneficiaries Age Greater 84 |
243 |
Number Of Female Beneficiaries |
863 |
Number Of Male Beneficiaries |
805 |
Number Of Non Hispanic White Beneficiaries |
1490 |
Number Of Black or African American Beneficiaries |
138 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
378 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9082 |