| National Provider Identifier [NPI]: | 1083721435 |
| Last Name Of The Provider | NEWSOME |
| First Name Of The Provider | KENDALL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 W. PARK ST. |
| Street Address 2 Of The Provider | RADIOLOGY |
| City Of The Provider | URBANA |
| Zip Code Of The Provider | 61801 |
| 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 | 136 |
| Number Of Services | 3567 |
| Number Of Medicare Beneficiaries | 2691 |
| Total Submitted Charge Amount | 762035 |
| Total Medicare Allowed Amount | 89838.4 |
| Total Medicare Payment Amount | 67322.84 |
| Total Medicare Standardized Payment Amount | 69199.72 |
| 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 | 136 |
| Number Of Medical Services | 3567 |
| Number Of Medicare Beneficiaries With Medical Services | 2691 |
| Total Medical Submitted Charge Amount | 762035 |
| Total Medical Medicare Allowed Amount | 89838.4 |
| Total Medical Medicare Payment Amount | 67322.84 |
| Total Medical Medicare Standardized Payment Amount | 69199.72 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 557 |
| Number Of Beneficiaries Age 65 to 74 | 1017 |
| Number Of Beneficiaries Age 75 to 84 | 750 |
| Number Of Beneficiaries Age Greater 84 | 367 |
| Number Of Female Beneficiaries | 1649 |
| Number Of Male Beneficiaries | 1042 |
| Number Of Non Hispanic White Beneficiaries | 2390 |
| Number Of Black or African American Beneficiaries | 208 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1985 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 706 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5195 |