| National Provider Identifier [NPI]: | 1508884826 |
| Last Name Of The Provider | MCMILLAN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4801 W 81ST ST |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 554371111 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 3419 |
| Number Of Medicare Beneficiaries | 1406 |
| Total Submitted Charge Amount | 411695.94 |
| Total Medicare Allowed Amount | 117723.05 |
| Total Medicare Payment Amount | 87946.61 |
| Total Medicare Standardized Payment Amount | 92530.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1219 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1410.94 |
| Total Drug Medicare AllowedAmount | 1163.81 |
| Total Drug Medicare PaymentAmount | 868.31 |
| Total Drug Medicare Standardized Payment Amount | 868.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 2200 |
| Number Of Medicare Beneficiaries With Medical Services | 1406 |
| Total Medical Submitted Charge Amount | 410285 |
| Total Medical Medicare Allowed Amount | 116559.24 |
| Total Medical Medicare Payment Amount | 87078.3 |
| Total Medical Medicare Standardized Payment Amount | 91661.99 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 450 |
| Number Of Beneficiaries Age 65 to 74 | 353 |
| Number Of Beneficiaries Age 75 to 84 | 372 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 832 |
| Number Of Male Beneficiaries | 574 |
| Number Of Non Hispanic White Beneficiaries | 1281 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 939 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 467 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6832 |