| National Provider Identifier [NPI]: | 1003835448 |
| Last Name Of The Provider | WEST |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2650 RIDGE AVE |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY, G507 |
| City Of The Provider | EVANSTON |
| Zip Code Of The Provider | 602011718 |
| 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 | 75 |
| Number Of Services | 8091 |
| Number Of Medicare Beneficiaries | 4923 |
| Total Submitted Charge Amount | 450158 |
| Total Medicare Allowed Amount | 149330.51 |
| Total Medicare Payment Amount | 130862.16 |
| Total Medicare Standardized Payment Amount | 121296.17 |
| 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 | 75 |
| Number Of Medical Services | 8091 |
| Number Of Medicare Beneficiaries With Medical Services | 4923 |
| Total Medical Submitted Charge Amount | 450158 |
| Total Medical Medicare Allowed Amount | 149330.51 |
| Total Medical Medicare Payment Amount | 130862.16 |
| Total Medical Medicare Standardized Payment Amount | 121296.17 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 261 |
| Number Of Beneficiaries Age 65 to 74 | 2045 |
| Number Of Beneficiaries Age 75 to 84 | 1623 |
| Number Of Beneficiaries Age Greater 84 | 994 |
| Number Of Female Beneficiaries | 3837 |
| Number Of Male Beneficiaries | 1086 |
| Number Of Non Hispanic White Beneficiaries | 4229 |
| Number Of Black or African American Beneficiaries | 241 |
| Number Of AsianPacific Islander Beneficiaries | 219 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 119 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4269 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 654 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3005 |