| National Provider Identifier [NPI]: | 1629058516 |
| Last Name Of The Provider | CULLENWARD |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| 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 | 261 |
| Number Of Services | 15040 |
| Number Of Medicare Beneficiaries | 2397 |
| Total Submitted Charge Amount | 1966694.84 |
| Total Medicare Allowed Amount | 226364.99 |
| Total Medicare Payment Amount | 175536.22 |
| Total Medicare Standardized Payment Amount | 184529.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 11164 |
| Number Of Medicare Beneficiaries With Drug Services | 139 |
| Total Drug Submitted ChargeAmount | 12541 |
| Total Drug Medicare AllowedAmount | 2897.55 |
| Total Drug Medicare PaymentAmount | 2052.62 |
| Total Drug Medicare Standardized Payment Amount | 2052.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 256 |
| Number Of Medical Services | 3876 |
| Number Of Medicare Beneficiaries With Medical Services | 2397 |
| Total Medical Submitted Charge Amount | 1954153.84 |
| Total Medical Medicare Allowed Amount | 223467.44 |
| Total Medical Medicare Payment Amount | 173483.6 |
| Total Medical Medicare Standardized Payment Amount | 182477.29 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 410 |
| Number Of Beneficiaries Age 65 to 74 | 958 |
| Number Of Beneficiaries Age 75 to 84 | 671 |
| Number Of Beneficiaries Age Greater 84 | 358 |
| Number Of Female Beneficiaries | 1508 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 2265 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1873 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 524 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3474 |