| National Provider Identifier [NPI]: | 1891749701 |
| Last Name Of The Provider | PIERCE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3849 N PERRYVILLE ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKFORD |
| Zip Code Of The Provider | 61114 |
| 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 | 186 |
| Number Of Services | 5936 |
| Number Of Medicare Beneficiaries | 2967 |
| Total Submitted Charge Amount | 1147419 |
| Total Medicare Allowed Amount | 178205.46 |
| Total Medicare Payment Amount | 137421.88 |
| Total Medicare Standardized Payment Amount | 141420.85 |
| 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 | 186 |
| Number Of Medical Services | 5936 |
| Number Of Medicare Beneficiaries With Medical Services | 2967 |
| Total Medical Submitted Charge Amount | 1147419 |
| Total Medical Medicare Allowed Amount | 178205.46 |
| Total Medical Medicare Payment Amount | 137421.88 |
| Total Medical Medicare Standardized Payment Amount | 141420.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 537 |
| Number Of Beneficiaries Age 65 to 74 | 994 |
| Number Of Beneficiaries Age 75 to 84 | 841 |
| Number Of Beneficiaries Age Greater 84 | 595 |
| Number Of Female Beneficiaries | 1881 |
| Number Of Male Beneficiaries | 1086 |
| Number Of Non Hispanic White Beneficiaries | 2690 |
| Number Of Black or African American Beneficiaries | 157 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2166 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 801 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3939 |