| National Provider Identifier [NPI]: | 1710032313 |
| Last Name Of The Provider | HALIO |
| First Name Of The Provider | MICHON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 N ROBERTSON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEVERLY HILLS |
| Zip Code Of The Provider | 902111788 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 7310 |
| Number Of Medicare Beneficiaries | 850 |
| Total Submitted Charge Amount | 337506.84 |
| Total Medicare Allowed Amount | 84170.1 |
| Total Medicare Payment Amount | 61941.92 |
| Total Medicare Standardized Payment Amount | 59057.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 6048 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 9072 |
| Total Drug Medicare AllowedAmount | 1098.93 |
| Total Drug Medicare PaymentAmount | 753 |
| Total Drug Medicare Standardized Payment Amount | 753 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 1262 |
| Number Of Medicare Beneficiaries With Medical Services | 850 |
| Total Medical Submitted Charge Amount | 328434.84 |
| Total Medical Medicare Allowed Amount | 83071.17 |
| Total Medical Medicare Payment Amount | 61188.92 |
| Total Medical Medicare Standardized Payment Amount | 58304.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 258 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 459 |
| Number Of Male Beneficiaries | 391 |
| Number Of Non Hispanic White Beneficiaries | 636 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 148 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 605 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 245 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2833 |