| National Provider Identifier [NPI]: | 1558353581 |
| Last Name Of The Provider | TILLMAN |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 VALLEY VIEW DR. |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | MOLINE |
| Zip Code Of The Provider | 612656180 |
| 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 | 230 |
| Number Of Services | 8460 |
| Number Of Medicare Beneficiaries | 5477 |
| Total Submitted Charge Amount | 823612.06 |
| Total Medicare Allowed Amount | 253950.98 |
| Total Medicare Payment Amount | 200055.84 |
| Total Medicare Standardized Payment Amount | 204568.79 |
| 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 | 230 |
| Number Of Medical Services | 8460 |
| Number Of Medicare Beneficiaries With Medical Services | 5477 |
| Total Medical Submitted Charge Amount | 823612.06 |
| Total Medical Medicare Allowed Amount | 253950.98 |
| Total Medical Medicare Payment Amount | 200055.84 |
| Total Medical Medicare Standardized Payment Amount | 204568.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 796 |
| Number Of Beneficiaries Age 65 to 74 | 2138 |
| Number Of Beneficiaries Age 75 to 84 | 1681 |
| Number Of Beneficiaries Age Greater 84 | 862 |
| Number Of Female Beneficiaries | 3413 |
| Number Of Male Beneficiaries | 2064 |
| Number Of Non Hispanic White Beneficiaries | 4961 |
| Number Of Black or African American Beneficiaries | 280 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 173 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4393 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1084 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4003 |