| National Provider Identifier [NPI]: | 1710967088 |
| Last Name Of The Provider | BENNETT |
| First Name Of The Provider | HAROLD |
| Middle Initial Of The Provider | F |
| 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 | 204 |
| Number Of Services | 11759 |
| Number Of Medicare Beneficiaries | 2394 |
| Total Submitted Charge Amount | 1590989 |
| Total Medicare Allowed Amount | 178132.15 |
| Total Medicare Payment Amount | 136643.46 |
| Total Medicare Standardized Payment Amount | 144059.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 8262 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 9064.5 |
| Total Drug Medicare AllowedAmount | 2616.33 |
| Total Drug Medicare PaymentAmount | 1849.79 |
| Total Drug Medicare Standardized Payment Amount | 1849.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 193 |
| Number Of Medical Services | 3497 |
| Number Of Medicare Beneficiaries With Medical Services | 2394 |
| Total Medical Submitted Charge Amount | 1581924.5 |
| Total Medical Medicare Allowed Amount | 175515.82 |
| Total Medical Medicare Payment Amount | 134793.67 |
| Total Medical Medicare Standardized Payment Amount | 142209.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 409 |
| Number Of Beneficiaries Age 65 to 74 | 926 |
| Number Of Beneficiaries Age 75 to 84 | 666 |
| Number Of Beneficiaries Age Greater 84 | 393 |
| Number Of Female Beneficiaries | 1507 |
| Number Of Male Beneficiaries | 887 |
| Number Of Non Hispanic White Beneficiaries | 2263 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1883 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 511 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3172 |