| National Provider Identifier [NPI]: | 1366552531 |
| Last Name Of The Provider | HARDIE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6150 WEST LAYTON AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENFIELD |
| Zip Code Of The Provider | 53220 |
| 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 | 179 |
| Number Of Services | 5183 |
| Number Of Medicare Beneficiaries | 3797 |
| Total Submitted Charge Amount | 1005802.25 |
| Total Medicare Allowed Amount | 151502.27 |
| Total Medicare Payment Amount | 113345.03 |
| Total Medicare Standardized Payment Amount | 119215.18 |
| 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 | 179 |
| Number Of Medical Services | 5183 |
| Number Of Medicare Beneficiaries With Medical Services | 3797 |
| Total Medical Submitted Charge Amount | 1005802.25 |
| Total Medical Medicare Allowed Amount | 151502.27 |
| Total Medical Medicare Payment Amount | 113345.03 |
| Total Medical Medicare Standardized Payment Amount | 119215.18 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 813 |
| Number Of Beneficiaries Age 65 to 74 | 1237 |
| Number Of Beneficiaries Age 75 to 84 | 1050 |
| Number Of Beneficiaries Age Greater 84 | 697 |
| Number Of Female Beneficiaries | 2152 |
| Number Of Male Beneficiaries | 1645 |
| Number Of Non Hispanic White Beneficiaries | 3089 |
| Number Of Black or African American Beneficiaries | 401 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 210 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1114 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0615 |