| National Provider Identifier [NPI]: | 1760443840 |
| Last Name Of The Provider | HEBRON |
| First Name Of The Provider | DELON |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2830 N 3RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850041042 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 1448 |
| Number Of Medicare Beneficiaries | 1046 |
| Total Submitted Charge Amount | 248527 |
| Total Medicare Allowed Amount | 53682.47 |
| Total Medicare Payment Amount | 38141.76 |
| Total Medicare Standardized Payment Amount | 39271.82 |
| 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 | 149 |
| Number Of Medical Services | 1448 |
| Number Of Medicare Beneficiaries With Medical Services | 1046 |
| Total Medical Submitted Charge Amount | 248527 |
| Total Medical Medicare Allowed Amount | 53682.47 |
| Total Medical Medicare Payment Amount | 38141.76 |
| Total Medical Medicare Standardized Payment Amount | 39271.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 388 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 551 |
| Number Of Male Beneficiaries | 495 |
| Number Of Non Hispanic White Beneficiaries | 803 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 123 |
| Number Of American Indian Alaska Native Beneficiaries | 22 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 756 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 290 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2598 |