| National Provider Identifier [NPI]: | 1306038906 |
| Last Name Of The Provider | MANNEM |
| First Name Of The Provider | RAJEEV |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9200 W WISCONSIN AVE |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532263522 |
| 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 | 136 |
| Number Of Services | 7219 |
| Number Of Medicare Beneficiaries | 2504 |
| Total Submitted Charge Amount | 643972.37 |
| Total Medicare Allowed Amount | 77961.64 |
| Total Medicare Payment Amount | 58444.27 |
| Total Medicare Standardized Payment Amount | 62239.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3022 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 10334.91 |
| Total Drug Medicare AllowedAmount | 586.96 |
| Total Drug Medicare PaymentAmount | 460.1 |
| Total Drug Medicare Standardized Payment Amount | 460.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 4197 |
| Number Of Medicare Beneficiaries With Medical Services | 2504 |
| Total Medical Submitted Charge Amount | 633637.46 |
| Total Medical Medicare Allowed Amount | 77374.68 |
| Total Medical Medicare Payment Amount | 57984.17 |
| Total Medical Medicare Standardized Payment Amount | 61779.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 673 |
| Number Of Beneficiaries Age 65 to 74 | 922 |
| Number Of Beneficiaries Age 75 to 84 | 584 |
| Number Of Beneficiaries Age Greater 84 | 325 |
| Number Of Female Beneficiaries | 1474 |
| Number Of Male Beneficiaries | 1030 |
| Number Of Non Hispanic White Beneficiaries | 1862 |
| Number Of Black or African American Beneficiaries | 496 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1688 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 816 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9866 |