| National Provider Identifier [NPI]: | 1255357612 |
| Last Name Of The Provider | HAN |
| First Name Of The Provider | PHYLLIS |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 S MILWAUKEE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIBERTYVILLE |
| Zip Code Of The Provider | 600483199 |
| 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 | 167 |
| Number Of Services | 5453 |
| Number Of Medicare Beneficiaries | 3288 |
| Total Submitted Charge Amount | 590318 |
| Total Medicare Allowed Amount | 164446.05 |
| Total Medicare Payment Amount | 125001.93 |
| Total Medicare Standardized Payment Amount | 120055.39 |
| 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 | 167 |
| Number Of Medical Services | 5453 |
| Number Of Medicare Beneficiaries With Medical Services | 3288 |
| Total Medical Submitted Charge Amount | 590318 |
| Total Medical Medicare Allowed Amount | 164446.05 |
| Total Medical Medicare Payment Amount | 125001.93 |
| Total Medical Medicare Standardized Payment Amount | 120055.39 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 388 |
| Number Of Beneficiaries Age 65 to 74 | 1137 |
| Number Of Beneficiaries Age 75 to 84 | 1050 |
| Number Of Beneficiaries Age Greater 84 | 713 |
| Number Of Female Beneficiaries | 2091 |
| Number Of Male Beneficiaries | 1197 |
| Number Of Non Hispanic White Beneficiaries | 2803 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | 88 |
| Number Of Hispanic Beneficiaries | 216 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2562 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 726 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7245 |