| National Provider Identifier [NPI]: | 1568662252 |
| Last Name Of The Provider | REYNOLDS |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 BROADWAY N |
| Street Address 2 Of The Provider | |
| City Of The Provider | FARGO |
| Zip Code Of The Provider | 581023641 |
| State Code Of The Provider | ND |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 3053 |
| Number Of Medicare Beneficiaries | 2223 |
| Total Submitted Charge Amount | 373555.5 |
| Total Medicare Allowed Amount | 125465.18 |
| Total Medicare Payment Amount | 90892.22 |
| Total Medicare Standardized Payment Amount | 94343.14 |
| 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 | 143 |
| Number Of Medical Services | 3053 |
| Number Of Medicare Beneficiaries With Medical Services | 2223 |
| Total Medical Submitted Charge Amount | 373555.5 |
| Total Medical Medicare Allowed Amount | 125465.18 |
| Total Medical Medicare Payment Amount | 90892.22 |
| Total Medical Medicare Standardized Payment Amount | 94343.14 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 455 |
| Number Of Beneficiaries Age 65 to 74 | 683 |
| Number Of Beneficiaries Age 75 to 84 | 647 |
| Number Of Beneficiaries Age Greater 84 | 438 |
| Number Of Female Beneficiaries | 1289 |
| Number Of Male Beneficiaries | 934 |
| Number Of Non Hispanic White Beneficiaries | 2090 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 73 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 524 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4671 |