| National Provider Identifier [NPI]: | 1255305884 |
| Last Name Of The Provider | HILDEBRANDT |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 22223 |
| Number Of Medicare Beneficiaries | 3194 |
| Total Submitted Charge Amount | 304594.19 |
| Total Medicare Allowed Amount | 190196.75 |
| Total Medicare Payment Amount | 138839.78 |
| Total Medicare Standardized Payment Amount | 156097.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 17566 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 4201.82 |
| Total Drug Medicare AllowedAmount | 3047.77 |
| Total Drug Medicare PaymentAmount | 1942.9 |
| Total Drug Medicare Standardized Payment Amount | 1942.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4657 |
| Number Of Medicare Beneficiaries With Medical Services | 3194 |
| Total Medical Submitted Charge Amount | 300392.37 |
| Total Medical Medicare Allowed Amount | 187148.98 |
| Total Medical Medicare Payment Amount | 136896.88 |
| Total Medical Medicare Standardized Payment Amount | 154154.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 451 |
| Number Of Beneficiaries Age 65 to 74 | 1348 |
| Number Of Beneficiaries Age 75 to 84 | 1010 |
| Number Of Beneficiaries Age Greater 84 | 385 |
| Number Of Female Beneficiaries | 1483 |
| Number Of Male Beneficiaries | 1711 |
| Number Of Non Hispanic White Beneficiaries | 3029 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2880 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 314 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6441 |