| National Provider Identifier [NPI]: | 1346441805 |
| Last Name Of The Provider | HOFFMEISTER |
| First Name Of The Provider | DEAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 W. PARK ST. |
| Street Address 2 Of The Provider | RADIOLOGY |
| City Of The Provider | URBANA |
| Zip Code Of The Provider | 618012500 |
| 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 | 135 |
| Number Of Services | 3141 |
| Number Of Medicare Beneficiaries | 2257 |
| Total Submitted Charge Amount | 800341 |
| Total Medicare Allowed Amount | 87725.15 |
| Total Medicare Payment Amount | 65406.73 |
| Total Medicare Standardized Payment Amount | 66802.04 |
| 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 | 135 |
| Number Of Medical Services | 3141 |
| Number Of Medicare Beneficiaries With Medical Services | 2257 |
| Total Medical Submitted Charge Amount | 800341 |
| Total Medical Medicare Allowed Amount | 87725.15 |
| Total Medical Medicare Payment Amount | 65406.73 |
| Total Medical Medicare Standardized Payment Amount | 66802.04 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 502 |
| Number Of Beneficiaries Age 65 to 74 | 864 |
| Number Of Beneficiaries Age 75 to 84 | 600 |
| Number Of Beneficiaries Age Greater 84 | 291 |
| Number Of Female Beneficiaries | 1317 |
| Number Of Male Beneficiaries | 940 |
| Number Of Non Hispanic White Beneficiaries | 1985 |
| Number Of Black or African American Beneficiaries | 186 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1657 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 600 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4315 |