| National Provider Identifier [NPI]: | 1194796391 |
| Last Name Of The Provider | SIBLEY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5001 US HIGHWAY 30 W STE D |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468189701 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 9681 |
| Number Of Medicare Beneficiaries | 6559 |
| Total Submitted Charge Amount | 1200917.37 |
| Total Medicare Allowed Amount | 294337.94 |
| Total Medicare Payment Amount | 218707.88 |
| Total Medicare Standardized Payment Amount | 230154.69 |
| 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 | 208 |
| Number Of Medical Services | 9681 |
| Number Of Medicare Beneficiaries With Medical Services | 6559 |
| Total Medical Submitted Charge Amount | 1200917.37 |
| Total Medical Medicare Allowed Amount | 294337.94 |
| Total Medical Medicare Payment Amount | 218707.88 |
| Total Medical Medicare Standardized Payment Amount | 230154.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1326 |
| Number Of Beneficiaries Age 65 to 74 | 2094 |
| Number Of Beneficiaries Age 75 to 84 | 1885 |
| Number Of Beneficiaries Age Greater 84 | 1254 |
| Number Of Female Beneficiaries | 3723 |
| Number Of Male Beneficiaries | 2836 |
| Number Of Non Hispanic White Beneficiaries | 6035 |
| Number Of Black or African American Beneficiaries | 332 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1938 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8463 |