| National Provider Identifier [NPI]: | 1285654913 |
| Last Name Of The Provider | ROZEBOOM |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 214 CARTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BERRYVILLE |
| Zip Code Of The Provider | 726164303 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 3234 |
| Number Of Medicare Beneficiaries | 1443 |
| Total Submitted Charge Amount | 389568 |
| Total Medicare Allowed Amount | 72409.14 |
| Total Medicare Payment Amount | 52841.35 |
| Total Medicare Standardized Payment Amount | 56730.84 |
| 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 | 101 |
| Number Of Medical Services | 3234 |
| Number Of Medicare Beneficiaries With Medical Services | 1443 |
| Total Medical Submitted Charge Amount | 389568 |
| Total Medical Medicare Allowed Amount | 72409.14 |
| Total Medical Medicare Payment Amount | 52841.35 |
| Total Medical Medicare Standardized Payment Amount | 56730.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 304 |
| Number Of Beneficiaries Age 65 to 74 | 532 |
| Number Of Beneficiaries Age 75 to 84 | 405 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 874 |
| Number Of Male Beneficiaries | 569 |
| Number Of Non Hispanic White Beneficiaries | 1427 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 930 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 513 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2055 |