| National Provider Identifier [NPI]: | 1932272002 |
| Last Name Of The Provider | HELLER |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1304 FAWCETT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984021911 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 11181 |
| Number Of Medicare Beneficiaries | 4583 |
| Total Submitted Charge Amount | 790902.81 |
| Total Medicare Allowed Amount | 206665.08 |
| Total Medicare Payment Amount | 152742.76 |
| Total Medicare Standardized Payment Amount | 154633.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4648 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 7702.5 |
| Total Drug Medicare AllowedAmount | 1748.65 |
| Total Drug Medicare PaymentAmount | 1334.98 |
| Total Drug Medicare Standardized Payment Amount | 1334.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 6533 |
| Number Of Medicare Beneficiaries With Medical Services | 4583 |
| Total Medical Submitted Charge Amount | 783200.31 |
| Total Medical Medicare Allowed Amount | 204916.43 |
| Total Medical Medicare Payment Amount | 151407.78 |
| Total Medical Medicare Standardized Payment Amount | 153298.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 872 |
| Number Of Beneficiaries Age 65 to 74 | 1590 |
| Number Of Beneficiaries Age 75 to 84 | 1321 |
| Number Of Beneficiaries Age Greater 84 | 800 |
| Number Of Female Beneficiaries | 2643 |
| Number Of Male Beneficiaries | 1940 |
| Number Of Non Hispanic White Beneficiaries | 3700 |
| Number Of Black or African American Beneficiaries | 307 |
| Number Of AsianPacific Islander Beneficiaries | 299 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | 56 |
| Number Of Beneficiaries With Race Not Else where Classified | 92 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1323 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7497 |