| National Provider Identifier [NPI]: | 1386917789 |
| Last Name Of The Provider | HAGE |
| First Name Of The Provider | JEAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4425 WELCOME WAY |
| Street Address 2 Of The Provider | STE 1 |
| City Of The Provider | DAVENPORT |
| Zip Code Of The Provider | 528064060 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 10121 |
| Number Of Medicare Beneficiaries | 630 |
| Total Submitted Charge Amount | 930862.98 |
| Total Medicare Allowed Amount | 420393.89 |
| Total Medicare Payment Amount | 325986.81 |
| Total Medicare Standardized Payment Amount | 333096.39 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 334 |
| Number Of Male Beneficiaries | 296 |
| Number Of Non Hispanic White Beneficiaries | 557 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.6883 |