| National Provider Identifier [NPI]: | 1831319284 |
| Last Name Of The Provider | KIBUULE |
| First Name Of The Provider | DANETTE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | DEPARTMENT OF RADIOLOGY |
| Street Address 2 Of The Provider | 981045 NEBRASKA MEDICAL CENTER |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681981045 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 2045 |
| Number Of Medicare Beneficiaries | 1495 |
| Total Submitted Charge Amount | 269195.22 |
| Total Medicare Allowed Amount | 57904.64 |
| Total Medicare Payment Amount | 43383.94 |
| Total Medicare Standardized Payment Amount | 45161.28 |
| 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 | 165 |
| Number Of Medical Services | 2045 |
| Number Of Medicare Beneficiaries With Medical Services | 1495 |
| Total Medical Submitted Charge Amount | 269195.22 |
| Total Medical Medicare Allowed Amount | 57904.64 |
| Total Medical Medicare Payment Amount | 43383.94 |
| Total Medical Medicare Standardized Payment Amount | 45161.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 529 |
| Number Of Beneficiaries Age 75 to 84 | 491 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 873 |
| Number Of Male Beneficiaries | 622 |
| Number Of Non Hispanic White Beneficiaries | 1303 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 313 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.939 |