| National Provider Identifier [NPI]: | 1740478494 |
| Last Name Of The Provider | SIBAI |
| First Name Of The Provider | SAMI |
| 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 | 611 W. PARK ST. |
| Street Address 2 Of The Provider | |
| City Of The Provider | URBANA |
| Zip Code Of The Provider | 618012500 |
| 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 | 148 |
| Number Of Services | 5770 |
| Number Of Medicare Beneficiaries | 3541 |
| Total Submitted Charge Amount | 1234572 |
| Total Medicare Allowed Amount | 169045.19 |
| Total Medicare Payment Amount | 130687.5 |
| Total Medicare Standardized Payment Amount | 131482.73 |
| 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 | 148 |
| Number Of Medical Services | 5770 |
| Number Of Medicare Beneficiaries With Medical Services | 3541 |
| Total Medical Submitted Charge Amount | 1234572 |
| Total Medical Medicare Allowed Amount | 169045.19 |
| Total Medical Medicare Payment Amount | 130687.5 |
| Total Medical Medicare Standardized Payment Amount | 131482.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 686 |
| Number Of Beneficiaries Age 65 to 74 | 1001 |
| Number Of Beneficiaries Age 75 to 84 | 1058 |
| Number Of Beneficiaries Age Greater 84 | 796 |
| Number Of Female Beneficiaries | 2052 |
| Number Of Male Beneficiaries | 1489 |
| Number Of Non Hispanic White Beneficiaries | 3126 |
| Number Of Black or African American Beneficiaries | 241 |
| Number Of AsianPacific Islander Beneficiaries | 67 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 952 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8886 |