| National Provider Identifier [NPI]: | 1326204850 |
| Last Name Of The Provider | RHEE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 W EDISON RD |
| Street Address 2 Of The Provider | STE 110 |
| City Of The Provider | MISHAWAKA |
| Zip Code Of The Provider | 465452784 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 4913 |
| Number Of Medicare Beneficiaries | 2989 |
| Total Submitted Charge Amount | 693075.15 |
| Total Medicare Allowed Amount | 165471.65 |
| Total Medicare Payment Amount | 123396.54 |
| Total Medicare Standardized Payment Amount | 130047.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 788 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 2052.87 |
| Total Drug Medicare AllowedAmount | 1705.38 |
| Total Drug Medicare PaymentAmount | 1321.05 |
| Total Drug Medicare Standardized Payment Amount | 1321.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 4125 |
| Number Of Medicare Beneficiaries With Medical Services | 2989 |
| Total Medical Submitted Charge Amount | 691022.28 |
| Total Medical Medicare Allowed Amount | 163766.27 |
| Total Medical Medicare Payment Amount | 122075.49 |
| Total Medical Medicare Standardized Payment Amount | 128725.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 549 |
| Number Of Beneficiaries Age 65 to 74 | 1053 |
| Number Of Beneficiaries Age 75 to 84 | 914 |
| Number Of Beneficiaries Age Greater 84 | 473 |
| Number Of Female Beneficiaries | 1696 |
| Number Of Male Beneficiaries | 1293 |
| Number Of Non Hispanic White Beneficiaries | 2687 |
| Number Of Black or African American Beneficiaries | 198 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 731 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5197 |