| National Provider Identifier [NPI]: | 1982750279 |
| Last Name Of The Provider | BIEBUYCK |
| First Name Of The Provider | JEAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 160 ALLEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUTLAND |
| Zip Code Of The Provider | 057014560 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 6343 |
| Number Of Medicare Beneficiaries | 3549 |
| Total Submitted Charge Amount | 897922.56 |
| Total Medicare Allowed Amount | 200430.3 |
| Total Medicare Payment Amount | 149200.13 |
| Total Medicare Standardized Payment Amount | 151277.62 |
| 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 | 194 |
| Number Of Medical Services | 6343 |
| Number Of Medicare Beneficiaries With Medical Services | 3549 |
| Total Medical Submitted Charge Amount | 897922.56 |
| Total Medical Medicare Allowed Amount | 200430.3 |
| Total Medical Medicare Payment Amount | 149200.13 |
| Total Medical Medicare Standardized Payment Amount | 151277.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 635 |
| Number Of Beneficiaries Age 65 to 74 | 1353 |
| Number Of Beneficiaries Age 75 to 84 | 1068 |
| Number Of Beneficiaries Age Greater 84 | 493 |
| Number Of Female Beneficiaries | 2334 |
| Number Of Male Beneficiaries | 1215 |
| Number Of Non Hispanic White Beneficiaries | 3445 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2423 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1126 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3313 |