| National Provider Identifier [NPI]: | 1730479676 |
| Last Name Of The Provider | HUEBNER |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4131 DANA LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAFAYETTE HILL |
| Zip Code Of The Provider | 194441343 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 4261 |
| Number Of Medicare Beneficiaries | 2010 |
| Total Submitted Charge Amount | 158664 |
| Total Medicare Allowed Amount | 67967.87 |
| Total Medicare Payment Amount | 48883.39 |
| Total Medicare Standardized Payment Amount | 50136.32 |
| 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 | 107 |
| Number Of Medical Services | 4261 |
| Number Of Medicare Beneficiaries With Medical Services | 2010 |
| Total Medical Submitted Charge Amount | 158664 |
| Total Medical Medicare Allowed Amount | 67967.87 |
| Total Medical Medicare Payment Amount | 48883.39 |
| Total Medical Medicare Standardized Payment Amount | 50136.32 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 809 |
| Number Of Beneficiaries Age 65 to 74 | 647 |
| Number Of Beneficiaries Age 75 to 84 | 386 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 1147 |
| Number Of Male Beneficiaries | 863 |
| Number Of Non Hispanic White Beneficiaries | 1207 |
| Number Of Black or African American Beneficiaries | 741 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1068 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 942 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1212 |