| National Provider Identifier [NPI]: | 1013991868 |
| Last Name Of The Provider | MCINTOSH |
| First Name Of The Provider | MARCY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2875 W 19TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606233501 |
| 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 | 230 |
| Number Of Services | 6226 |
| Number Of Medicare Beneficiaries | 2787 |
| Total Submitted Charge Amount | 638148.84 |
| Total Medicare Allowed Amount | 168328.39 |
| Total Medicare Payment Amount | 132976.81 |
| Total Medicare Standardized Payment Amount | 135517.97 |
| 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 | 230 |
| Number Of Medical Services | 6226 |
| Number Of Medicare Beneficiaries With Medical Services | 2787 |
| Total Medical Submitted Charge Amount | 638148.84 |
| Total Medical Medicare Allowed Amount | 168328.39 |
| Total Medical Medicare Payment Amount | 132976.81 |
| Total Medical Medicare Standardized Payment Amount | 135517.97 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 618 |
| Number Of Beneficiaries Age 65 to 74 | 1144 |
| Number Of Beneficiaries Age 75 to 84 | 632 |
| Number Of Beneficiaries Age Greater 84 | 393 |
| Number Of Female Beneficiaries | 1730 |
| Number Of Male Beneficiaries | 1057 |
| Number Of Non Hispanic White Beneficiaries | 2318 |
| Number Of Black or African American Beneficiaries | 386 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1913 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 874 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6583 |