| National Provider Identifier [NPI]: | 1427190727 |
| Last Name Of The Provider | BLUME |
| First Name Of The Provider | DOUGLAS |
| 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 | 2400 N ROCKTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKFORD |
| Zip Code Of The Provider | 611033655 |
| 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 | 227 |
| Number Of Services | 8072 |
| Number Of Medicare Beneficiaries | 4604 |
| Total Submitted Charge Amount | 1380344.5 |
| Total Medicare Allowed Amount | 195964.51 |
| Total Medicare Payment Amount | 154215.71 |
| Total Medicare Standardized Payment Amount | 158033.99 |
| 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 | 227 |
| Number Of Medical Services | 8072 |
| Number Of Medicare Beneficiaries With Medical Services | 4604 |
| Total Medical Submitted Charge Amount | 1380344.5 |
| Total Medical Medicare Allowed Amount | 195964.51 |
| Total Medical Medicare Payment Amount | 154215.71 |
| Total Medical Medicare Standardized Payment Amount | 158033.99 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 910 |
| Number Of Beneficiaries Age 65 to 74 | 1672 |
| Number Of Beneficiaries Age 75 to 84 | 1313 |
| Number Of Beneficiaries Age Greater 84 | 709 |
| Number Of Female Beneficiaries | 2985 |
| Number Of Male Beneficiaries | 1619 |
| Number Of Non Hispanic White Beneficiaries | 3972 |
| Number Of Black or African American Beneficiaries | 415 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 134 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1212 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5775 |