| National Provider Identifier [NPI]: | 1700048923 |
| Last Name Of The Provider | MCCREA |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 S SAINT LOUIS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466172924 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 7489 |
| Number Of Medicare Beneficiaries | 3431 |
| Total Submitted Charge Amount | 704769.46 |
| Total Medicare Allowed Amount | 228420.08 |
| Total Medicare Payment Amount | 169836.36 |
| Total Medicare Standardized Payment Amount | 180326.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1927 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 4689.64 |
| Total Drug Medicare AllowedAmount | 4392.39 |
| Total Drug Medicare PaymentAmount | 3392.03 |
| Total Drug Medicare Standardized Payment Amount | 3392.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 5562 |
| Number Of Medicare Beneficiaries With Medical Services | 3431 |
| Total Medical Submitted Charge Amount | 700079.82 |
| Total Medical Medicare Allowed Amount | 224027.69 |
| Total Medical Medicare Payment Amount | 166444.33 |
| Total Medical Medicare Standardized Payment Amount | 176934.89 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 730 |
| Number Of Beneficiaries Age 65 to 74 | 1069 |
| Number Of Beneficiaries Age 75 to 84 | 966 |
| Number Of Beneficiaries Age Greater 84 | 666 |
| Number Of Female Beneficiaries | 2025 |
| Number Of Male Beneficiaries | 1406 |
| Number Of Non Hispanic White Beneficiaries | 3088 |
| Number Of Black or African American Beneficiaries | 237 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 947 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.725 |