National Provider Identifier [NPI]: |
1154536530 |
Last Name Of The Provider |
HONG |
First Name Of The Provider |
STEVE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
611 WEST PARK STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
URBANA |
Zip Code Of The Provider |
618012500 |
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 |
144 |
Number Of Services |
977 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
1361140 |
Total Medicare Allowed Amount |
86574.7 |
Total Medicare Payment Amount |
65458.21 |
Total Medicare Standardized Payment Amount |
67766.17 |
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 |
144 |
Number Of Medical Services |
977 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
1361140 |
Total Medical Medicare Allowed Amount |
86574.7 |
Total Medical Medicare Payment Amount |
65458.21 |
Total Medical Medicare Standardized Payment Amount |
67766.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
410 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
335 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2498 |