| National Provider Identifier [NPI]: | 1487607982 |
| Last Name Of The Provider | HOLDENER |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 WEST LINCOLN STREET |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | BELLEVILLE |
| Zip Code Of The Provider | 62220 |
| 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 | 163 |
| Number Of Services | 4785 |
| Number Of Medicare Beneficiaries | 2733 |
| Total Submitted Charge Amount | 472524 |
| Total Medicare Allowed Amount | 126290.61 |
| Total Medicare Payment Amount | 94786.98 |
| Total Medicare Standardized Payment Amount | 94198.39 |
| 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 | 163 |
| Number Of Medical Services | 4785 |
| Number Of Medicare Beneficiaries With Medical Services | 2733 |
| Total Medical Submitted Charge Amount | 472524 |
| Total Medical Medicare Allowed Amount | 126290.61 |
| Total Medical Medicare Payment Amount | 94786.98 |
| Total Medical Medicare Standardized Payment Amount | 94198.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 685 |
| Number Of Beneficiaries Age 65 to 74 | 902 |
| Number Of Beneficiaries Age 75 to 84 | 734 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 1750 |
| Number Of Male Beneficiaries | 983 |
| Number Of Non Hispanic White Beneficiaries | 2071 |
| Number Of Black or African American Beneficiaries | 603 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1810 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 923 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5576 |