| National Provider Identifier [NPI]: | 1649235896 |
| Last Name Of The Provider | PANICO |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 818 E BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPARTA |
| Zip Code Of The Provider | 62288 |
| 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 | 168 |
| Number Of Services | 5029 |
| Number Of Medicare Beneficiaries | 1797 |
| Total Submitted Charge Amount | 466247 |
| Total Medicare Allowed Amount | 156467.04 |
| Total Medicare Payment Amount | 118474.31 |
| Total Medicare Standardized Payment Amount | 117713.99 |
| 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 | 168 |
| Number Of Medical Services | 5029 |
| Number Of Medicare Beneficiaries With Medical Services | 1797 |
| Total Medical Submitted Charge Amount | 466247 |
| Total Medical Medicare Allowed Amount | 156467.04 |
| Total Medical Medicare Payment Amount | 118474.31 |
| Total Medical Medicare Standardized Payment Amount | 117713.99 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 349 |
| Number Of Beneficiaries Age 65 to 74 | 685 |
| Number Of Beneficiaries Age 75 to 84 | 471 |
| Number Of Beneficiaries Age Greater 84 | 292 |
| Number Of Female Beneficiaries | 1091 |
| Number Of Male Beneficiaries | 706 |
| Number Of Non Hispanic White Beneficiaries | 1683 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1361 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 436 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2161 |