| National Provider Identifier [NPI]: | 1144287590 |
| Last Name Of The Provider | HEGGEN |
| First Name Of The Provider | CHARLES |
| 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 | 12368 STRATFORD DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | CLIVE |
| Zip Code Of The Provider | 503258162 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 6166 |
| Number Of Medicare Beneficiaries | 2680 |
| Total Submitted Charge Amount | 392671.57 |
| Total Medicare Allowed Amount | 142386.64 |
| Total Medicare Payment Amount | 109118.3 |
| Total Medicare Standardized Payment Amount | 116456.99 |
| 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 | 170 |
| Number Of Medical Services | 6166 |
| Number Of Medicare Beneficiaries With Medical Services | 2680 |
| Total Medical Submitted Charge Amount | 392671.57 |
| Total Medical Medicare Allowed Amount | 142386.64 |
| Total Medical Medicare Payment Amount | 109118.3 |
| Total Medical Medicare Standardized Payment Amount | 116456.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 372 |
| Number Of Beneficiaries Age 65 to 74 | 918 |
| Number Of Beneficiaries Age 75 to 84 | 854 |
| Number Of Beneficiaries Age Greater 84 | 536 |
| Number Of Female Beneficiaries | 1587 |
| Number Of Male Beneficiaries | 1093 |
| Number Of Non Hispanic White Beneficiaries | 2511 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2151 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 529 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3928 |