| National Provider Identifier [NPI]: | 1780685529 |
| Last Name Of The Provider | HUMES |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 VALLEY VIEW DR |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | MOLINE |
| Zip Code Of The Provider | 612656180 |
| 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 | 216 |
| Number Of Services | 5588 |
| Number Of Medicare Beneficiaries | 3949 |
| Total Submitted Charge Amount | 675212.13 |
| Total Medicare Allowed Amount | 205539.36 |
| Total Medicare Payment Amount | 159752.78 |
| Total Medicare Standardized Payment Amount | 165161.17 |
| 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 | 216 |
| Number Of Medical Services | 5588 |
| Number Of Medicare Beneficiaries With Medical Services | 3949 |
| Total Medical Submitted Charge Amount | 675212.13 |
| Total Medical Medicare Allowed Amount | 205539.36 |
| Total Medical Medicare Payment Amount | 159752.78 |
| Total Medical Medicare Standardized Payment Amount | 165161.17 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 577 |
| Number Of Beneficiaries Age 65 to 74 | 1460 |
| Number Of Beneficiaries Age 75 to 84 | 1209 |
| Number Of Beneficiaries Age Greater 84 | 703 |
| Number Of Female Beneficiaries | 2344 |
| Number Of Male Beneficiaries | 1605 |
| Number Of Non Hispanic White Beneficiaries | 3607 |
| Number Of Black or African American Beneficiaries | 189 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 103 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 839 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.493 |