| National Provider Identifier [NPI]: | 1962407197 |
| Last Name Of The Provider | VANDERKIN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 W HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MORRIS |
| Zip Code Of The Provider | 604501463 |
| 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 | 161 |
| Number Of Services | 7146 |
| Number Of Medicare Beneficiaries | 3238 |
| Total Submitted Charge Amount | 696636 |
| Total Medicare Allowed Amount | 181470.91 |
| Total Medicare Payment Amount | 141140.32 |
| Total Medicare Standardized Payment Amount | 143520.25 |
| 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 | 161 |
| Number Of Medical Services | 7146 |
| Number Of Medicare Beneficiaries With Medical Services | 3238 |
| Total Medical Submitted Charge Amount | 696636 |
| Total Medical Medicare Allowed Amount | 181470.91 |
| Total Medical Medicare Payment Amount | 141140.32 |
| Total Medical Medicare Standardized Payment Amount | 143520.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 461 |
| Number Of Beneficiaries Age 65 to 74 | 1396 |
| Number Of Beneficiaries Age 75 to 84 | 953 |
| Number Of Beneficiaries Age Greater 84 | 428 |
| Number Of Female Beneficiaries | 2212 |
| Number Of Male Beneficiaries | 1026 |
| Number Of Non Hispanic White Beneficiaries | 3106 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 82 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2685 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 553 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3104 |