| National Provider Identifier [NPI]: | 1699755579 |
| Last Name Of The Provider | BUENCAMINO |
| First Name Of The Provider | CENON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 S PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537151849 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 14394 |
| Number Of Medicare Beneficiaries | 3107 |
| Total Submitted Charge Amount | 1989005.25 |
| Total Medicare Allowed Amount | 234389.37 |
| Total Medicare Payment Amount | 180312.33 |
| Total Medicare Standardized Payment Amount | 189771.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 9599 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 11582.25 |
| Total Drug Medicare AllowedAmount | 3498.39 |
| Total Drug Medicare PaymentAmount | 2611.81 |
| Total Drug Medicare Standardized Payment Amount | 2611.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 183 |
| Number Of Medical Services | 4795 |
| Number Of Medicare Beneficiaries With Medical Services | 3106 |
| Total Medical Submitted Charge Amount | 1977423 |
| Total Medical Medicare Allowed Amount | 230890.98 |
| Total Medical Medicare Payment Amount | 177700.52 |
| Total Medical Medicare Standardized Payment Amount | 187159.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 526 |
| Number Of Beneficiaries Age 65 to 74 | 1254 |
| Number Of Beneficiaries Age 75 to 84 | 849 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 1958 |
| Number Of Male Beneficiaries | 1149 |
| Number Of Non Hispanic White Beneficiaries | 2944 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2495 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 612 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1864 |