| National Provider Identifier [NPI]: | 1114915527 |
| Last Name Of The Provider | MIRSKY |
| First Name Of The Provider | ROMAN |
| 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 | 1111 6TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503142613 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 8225 |
| Number Of Medicare Beneficiaries | 4937 |
| Total Submitted Charge Amount | 786755.59 |
| Total Medicare Allowed Amount | 202155.24 |
| Total Medicare Payment Amount | 161601.33 |
| Total Medicare Standardized Payment Amount | 172268.7 |
| 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 | 169 |
| Number Of Medical Services | 8225 |
| Number Of Medicare Beneficiaries With Medical Services | 4937 |
| Total Medical Submitted Charge Amount | 786755.59 |
| Total Medical Medicare Allowed Amount | 202155.24 |
| Total Medical Medicare Payment Amount | 161601.33 |
| Total Medical Medicare Standardized Payment Amount | 172268.7 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 698 |
| Number Of Beneficiaries Age 65 to 74 | 1849 |
| Number Of Beneficiaries Age 75 to 84 | 1500 |
| Number Of Beneficiaries Age Greater 84 | 890 |
| Number Of Female Beneficiaries | 3273 |
| Number Of Male Beneficiaries | 1664 |
| Number Of Non Hispanic White Beneficiaries | 4684 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3786 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1151 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4693 |