| National Provider Identifier [NPI]: | 1194894311 |
| Last Name Of The Provider | PIACENTI |
| First Name Of The Provider | MERLE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 E FIRST STREET |
| Street Address 2 Of The Provider | ST MARGARETS HOSPITAL |
| City Of The Provider | SPRING VALLEY |
| Zip Code Of The Provider | 613621512 |
| 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 | 170 |
| Number Of Services | 5477 |
| Number Of Medicare Beneficiaries | 2959 |
| Total Submitted Charge Amount | 418890.36 |
| Total Medicare Allowed Amount | 147161.95 |
| Total Medicare Payment Amount | 112313.12 |
| Total Medicare Standardized Payment Amount | 114979.9 |
| 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 | 170 |
| Number Of Medical Services | 5477 |
| Number Of Medicare Beneficiaries With Medical Services | 2959 |
| Total Medical Submitted Charge Amount | 418890.36 |
| Total Medical Medicare Allowed Amount | 147161.95 |
| Total Medical Medicare Payment Amount | 112313.12 |
| Total Medical Medicare Standardized Payment Amount | 114979.9 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 351 |
| Number Of Beneficiaries Age 65 to 74 | 1080 |
| Number Of Beneficiaries Age 75 to 84 | 911 |
| Number Of Beneficiaries Age Greater 84 | 617 |
| Number Of Female Beneficiaries | 1882 |
| Number Of Male Beneficiaries | 1077 |
| Number Of Non Hispanic White Beneficiaries | 2816 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 95 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 555 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3276 |