| National Provider Identifier [NPI]: | 1811959620 |
| Last Name Of The Provider | BENEDETTI |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1813 W HARVARD AVE |
| Street Address 2 Of The Provider | SUITE 432 |
| City Of The Provider | ROSEBURG |
| Zip Code Of The Provider | 974712752 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 5784 |
| Number Of Medicare Beneficiaries | 3296 |
| Total Submitted Charge Amount | 509441.81 |
| Total Medicare Allowed Amount | 157467.92 |
| Total Medicare Payment Amount | 120955.52 |
| Total Medicare Standardized Payment Amount | 125642.48 |
| 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 | 196 |
| Number Of Medical Services | 5784 |
| Number Of Medicare Beneficiaries With Medical Services | 3296 |
| Total Medical Submitted Charge Amount | 509441.81 |
| Total Medical Medicare Allowed Amount | 157467.92 |
| Total Medical Medicare Payment Amount | 120955.52 |
| Total Medical Medicare Standardized Payment Amount | 125642.48 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 451 |
| Number Of Beneficiaries Age 65 to 74 | 1387 |
| Number Of Beneficiaries Age 75 to 84 | 1008 |
| Number Of Beneficiaries Age Greater 84 | 450 |
| Number Of Female Beneficiaries | 2214 |
| Number Of Male Beneficiaries | 1082 |
| Number Of Non Hispanic White Beneficiaries | 3167 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | 42 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2758 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 538 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.238 |