National Provider Identifier [NPI]: |
1083653885 |
Last Name Of The Provider |
WILLING |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5901 TECHNOLOGY CENTER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462786013 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
3881 |
Number Of Medicare Beneficiaries |
2466 |
Total Submitted Charge Amount |
573261.1 |
Total Medicare Allowed Amount |
171324.72 |
Total Medicare Payment Amount |
131515.35 |
Total Medicare Standardized Payment Amount |
138926.03 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
608 |
Number Of Beneficiaries Age 65 to 74 |
815 |
Number Of Beneficiaries Age 75 to 84 |
660 |
Number Of Beneficiaries Age Greater 84 |
383 |
Number Of Female Beneficiaries |
1474 |
Number Of Male Beneficiaries |
992 |
Number Of Non Hispanic White Beneficiaries |
2186 |
Number Of Black or African American Beneficiaries |
228 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
1718 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
748 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.6333 |