| National Provider Identifier [NPI]: | 1609857242 |
| Last Name Of The Provider | THIMM |
| First Name Of The Provider | ERWIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12251 S 80TH AVE |
| Street Address 2 Of The Provider | PALOS COMMUNITY HOSPITAL |
| City Of The Provider | PALOS HEIGHTS |
| Zip Code Of The Provider | 60463 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 9591 |
| Number Of Medicare Beneficiaries | 5191 |
| Total Submitted Charge Amount | 1060861 |
| Total Medicare Allowed Amount | 305984.07 |
| Total Medicare Payment Amount | 244656.1 |
| Total Medicare Standardized Payment Amount | 230986.87 |
| 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 | 163 |
| Number Of Medical Services | 9591 |
| Number Of Medicare Beneficiaries With Medical Services | 5191 |
| Total Medical Submitted Charge Amount | 1060861 |
| Total Medical Medicare Allowed Amount | 305984.07 |
| Total Medical Medicare Payment Amount | 244656.1 |
| Total Medical Medicare Standardized Payment Amount | 230986.87 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 2171 |
| Number Of Beneficiaries Age 75 to 84 | 1740 |
| Number Of Beneficiaries Age Greater 84 | 957 |
| Number Of Female Beneficiaries | 3797 |
| Number Of Male Beneficiaries | 1394 |
| Number Of Non Hispanic White Beneficiaries | 4840 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 131 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4705 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 486 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4736 |