| National Provider Identifier [NPI]: | 1306026778 |
| Last Name Of The Provider | HILL |
| First Name Of The Provider | JUSTIN |
| 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 | 400 EAST 3RD STREET |
| Street Address 2 Of The Provider | DULUTH CLINIC |
| City Of The Provider | DULUTH |
| Zip Code Of The Provider | 55805 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 3262 |
| Number Of Medicare Beneficiaries | 1959 |
| Total Submitted Charge Amount | 925331.5 |
| Total Medicare Allowed Amount | 131128 |
| Total Medicare Payment Amount | 97488.28 |
| Total Medicare Standardized Payment Amount | 100149.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 223 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 3064.5 |
| Total Drug Medicare AllowedAmount | 426.26 |
| Total Drug Medicare PaymentAmount | 326.83 |
| Total Drug Medicare Standardized Payment Amount | 326.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 3039 |
| Number Of Medicare Beneficiaries With Medical Services | 1957 |
| Total Medical Submitted Charge Amount | 922267 |
| Total Medical Medicare Allowed Amount | 130701.74 |
| Total Medical Medicare Payment Amount | 97161.45 |
| Total Medical Medicare Standardized Payment Amount | 99822.95 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 619 |
| Number Of Beneficiaries Age 65 to 74 | 611 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 294 |
| Number Of Female Beneficiaries | 1058 |
| Number Of Male Beneficiaries | 901 |
| Number Of Non Hispanic White Beneficiaries | 1777 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 111 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 791 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5982 |