| National Provider Identifier [NPI]: | 1194981712 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 429 S LANDMARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 474035003 |
| 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 | 167 |
| Number Of Services | 20063 |
| Number Of Medicare Beneficiaries | 2891 |
| Total Submitted Charge Amount | 934463.88 |
| Total Medicare Allowed Amount | 227463.99 |
| Total Medicare Payment Amount | 172249.52 |
| Total Medicare Standardized Payment Amount | 183702.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 16053 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 18035.88 |
| Total Drug Medicare AllowedAmount | 3619.61 |
| Total Drug Medicare PaymentAmount | 2826.42 |
| Total Drug Medicare Standardized Payment Amount | 2826.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 4010 |
| Number Of Medicare Beneficiaries With Medical Services | 2891 |
| Total Medical Submitted Charge Amount | 916428 |
| Total Medical Medicare Allowed Amount | 223844.38 |
| Total Medical Medicare Payment Amount | 169423.1 |
| Total Medical Medicare Standardized Payment Amount | 180875.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 533 |
| Number Of Beneficiaries Age 65 to 74 | 1098 |
| Number Of Beneficiaries Age 75 to 84 | 854 |
| Number Of Beneficiaries Age Greater 84 | 406 |
| Number Of Female Beneficiaries | 1697 |
| Number Of Male Beneficiaries | 1194 |
| Number Of Non Hispanic White Beneficiaries | 2807 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 659 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3687 |