National Provider Identifier [NPI]: |
1689785024 |
Last Name Of The Provider |
HERRON |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1880 HOLLISTER DRIVE |
Street Address 2 Of The Provider |
SUITE G-18 |
City Of The Provider |
LIBERTYVILLE |
Zip Code Of The Provider |
600485263 |
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 |
137 |
Number Of Services |
7798 |
Number Of Medicare Beneficiaries |
3546 |
Total Submitted Charge Amount |
1377635.4 |
Total Medicare Allowed Amount |
387807.31 |
Total Medicare Payment Amount |
338954.85 |
Total Medicare Standardized Payment Amount |
326832.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1547 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
5256.5 |
Total Drug Medicare AllowedAmount |
568.45 |
Total Drug Medicare PaymentAmount |
445.65 |
Total Drug Medicare Standardized Payment Amount |
445.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
135 |
Number Of Medical Services |
6251 |
Number Of Medicare Beneficiaries With Medical Services |
3546 |
Total Medical Submitted Charge Amount |
1372378.9 |
Total Medical Medicare Allowed Amount |
387238.86 |
Total Medical Medicare Payment Amount |
338509.2 |
Total Medical Medicare Standardized Payment Amount |
326386.77 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
689 |
Number Of Beneficiaries Age 65 to 74 |
1369 |
Number Of Beneficiaries Age 75 to 84 |
1013 |
Number Of Beneficiaries Age Greater 84 |
475 |
Number Of Female Beneficiaries |
2657 |
Number Of Male Beneficiaries |
889 |
Number Of Non Hispanic White Beneficiaries |
2531 |
Number Of Black or African American Beneficiaries |
325 |
Number Of AsianPacific Islander Beneficiaries |
314 |
Number Of Hispanic Beneficiaries |
296 |
Number Of American Indian Alaska Native Beneficiaries |
11 |
Number Of Beneficiaries With Race Not Else where Classified |
69 |
Number Of Beneficiaries With Medicare Only Entitlement |
2389 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1157 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4658 |