| National Provider Identifier [NPI]: | 1790987469 |
| Last Name Of The Provider | CHANEY |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2160 S 1ST AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MAYWOOD |
| Zip Code Of The Provider | 601533328 |
| 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 | 177 |
| Number Of Services | 6759 |
| Number Of Medicare Beneficiaries | 3676 |
| Total Submitted Charge Amount | 897400 |
| Total Medicare Allowed Amount | 222140.09 |
| Total Medicare Payment Amount | 174371.45 |
| Total Medicare Standardized Payment Amount | 167006.43 |
| 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 | 177 |
| Number Of Medical Services | 6759 |
| Number Of Medicare Beneficiaries With Medical Services | 3676 |
| Total Medical Submitted Charge Amount | 897400 |
| Total Medical Medicare Allowed Amount | 222140.09 |
| Total Medical Medicare Payment Amount | 174371.45 |
| Total Medical Medicare Standardized Payment Amount | 167006.43 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 489 |
| Number Of Beneficiaries Age 65 to 74 | 1411 |
| Number Of Beneficiaries Age 75 to 84 | 1115 |
| Number Of Beneficiaries Age Greater 84 | 661 |
| Number Of Female Beneficiaries | 2166 |
| Number Of Male Beneficiaries | 1510 |
| Number Of Non Hispanic White Beneficiaries | 3212 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 213 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2938 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 738 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5441 |