| National Provider Identifier [NPI]: | 1730184086 |
| Last Name Of The Provider | HIZON |
| First Name Of The Provider | MIGUEL |
| 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 | 455 W COURT ST |
| Street Address 2 Of The Provider | STE 304 |
| City Of The Provider | KANKAKEE |
| Zip Code Of The Provider | 609013694 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 6614 |
| Number Of Medicare Beneficiaries | 1062 |
| Total Submitted Charge Amount | 950112 |
| Total Medicare Allowed Amount | 662386.73 |
| Total Medicare Payment Amount | 502912.16 |
| Total Medicare Standardized Payment Amount | 465651.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 1322 |
| Total Drug Medicare AllowedAmount | 1202.21 |
| Total Drug Medicare PaymentAmount | 1173.12 |
| Total Drug Medicare Standardized Payment Amount | 1173.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 6565 |
| Number Of Medicare Beneficiaries With Medical Services | 1062 |
| Total Medical Submitted Charge Amount | 948790 |
| Total Medical Medicare Allowed Amount | 661184.52 |
| Total Medical Medicare Payment Amount | 501739.04 |
| Total Medical Medicare Standardized Payment Amount | 464478.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 214 |
| Number Of Beneficiaries Age 65 to 74 | 320 |
| Number Of Beneficiaries Age 75 to 84 | 337 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 561 |
| Number Of Male Beneficiaries | 501 |
| Number Of Non Hispanic White Beneficiaries | 861 |
| Number Of Black or African American Beneficiaries | 176 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 732 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 330 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.8893 |