| National Provider Identifier [NPI]: | 1326067117 |
| Last Name Of The Provider | ROCKWELL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3264 N EVERGREEN DR NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495259746 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 5303 |
| Number Of Medicare Beneficiaries | 1889 |
| Total Submitted Charge Amount | 1049543 |
| Total Medicare Allowed Amount | 173505.44 |
| Total Medicare Payment Amount | 133102.83 |
| Total Medicare Standardized Payment Amount | 141455.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2553 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 10255 |
| Total Drug Medicare AllowedAmount | 2489.22 |
| Total Drug Medicare PaymentAmount | 1925.38 |
| Total Drug Medicare Standardized Payment Amount | 1925.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 2750 |
| Number Of Medicare Beneficiaries With Medical Services | 1889 |
| Total Medical Submitted Charge Amount | 1039288 |
| Total Medical Medicare Allowed Amount | 171016.22 |
| Total Medical Medicare Payment Amount | 131177.45 |
| Total Medical Medicare Standardized Payment Amount | 139530.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 455 |
| Number Of Beneficiaries Age 65 to 74 | 574 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 337 |
| Number Of Female Beneficiaries | 1078 |
| Number Of Male Beneficiaries | 811 |
| Number Of Non Hispanic White Beneficiaries | 1668 |
| Number Of Black or African American Beneficiaries | 150 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1347 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.7027 |