| National Provider Identifier [NPI]: | 1831318195 |
| Last Name Of The Provider | RIESENMAN |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1350 WALTON WAY; 2ND FLOOR |
| Street Address 2 Of The Provider | UNIVERSITY HOSPITAL/VASCULAR SPECIALISTS |
| City Of The Provider | AUGUSTA |
| Zip Code Of The Provider | 30901 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 3273 |
| Number Of Medicare Beneficiaries | 1165 |
| Total Submitted Charge Amount | 1883807.75 |
| Total Medicare Allowed Amount | 299468.77 |
| Total Medicare Payment Amount | 231002.34 |
| Total Medicare Standardized Payment Amount | 238448.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 3273 |
| Number Of Medicare Beneficiaries With Medical Services | 1165 |
| Total Medical Submitted Charge Amount | 1883807.75 |
| Total Medical Medicare Allowed Amount | 299468.77 |
| Total Medical Medicare Payment Amount | 231002.34 |
| Total Medical Medicare Standardized Payment Amount | 238448.03 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 450 |
| Number Of Beneficiaries Age 75 to 84 | 385 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 614 |
| Number Of Male Beneficiaries | 551 |
| Number Of Non Hispanic White Beneficiaries | 809 |
| Number Of Black or African American Beneficiaries | 330 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 904 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2253 |