| National Provider Identifier [NPI]: | 1043204308 |
| Last Name Of The Provider | ELLERBROEK |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 PLEASANT ST |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503091423 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 138 |
| Number Of Services | 37197 |
| Number Of Medicare Beneficiaries | 2502 |
| Total Submitted Charge Amount | 1234816.8 |
| Total Medicare Allowed Amount | 370847.94 |
| Total Medicare Payment Amount | 296284.18 |
| Total Medicare Standardized Payment Amount | 336310.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 33114 |
| Number Of Medicare Beneficiaries With Drug Services | 373 |
| Total Drug Submitted ChargeAmount | 42092.8 |
| Total Drug Medicare AllowedAmount | 6838.28 |
| Total Drug Medicare PaymentAmount | 5323.61 |
| Total Drug Medicare Standardized Payment Amount | 5323.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 4083 |
| Number Of Medicare Beneficiaries With Medical Services | 2501 |
| Total Medical Submitted Charge Amount | 1192724 |
| Total Medical Medicare Allowed Amount | 364009.66 |
| Total Medical Medicare Payment Amount | 290960.57 |
| Total Medical Medicare Standardized Payment Amount | 330987.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 1270 |
| Number Of Beneficiaries Age 75 to 84 | 773 |
| Number Of Beneficiaries Age Greater 84 | 254 |
| Number Of Female Beneficiaries | 1777 |
| Number Of Male Beneficiaries | 725 |
| Number Of Non Hispanic White Beneficiaries | 2399 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 220 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0609 |