| National Provider Identifier [NPI]: | 1952381766 |
| Last Name Of The Provider | MCKINNON |
| First Name Of The Provider | SALLY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 S PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537151849 |
| 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 | 164 |
| Number Of Services | 20492 |
| Number Of Medicare Beneficiaries | 2578 |
| Total Submitted Charge Amount | 2571931.75 |
| Total Medicare Allowed Amount | 242992.12 |
| Total Medicare Payment Amount | 187569.75 |
| Total Medicare Standardized Payment Amount | 197361.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 16550 |
| Number Of Medicare Beneficiaries With Drug Services | 196 |
| Total Drug Submitted ChargeAmount | 15909.75 |
| Total Drug Medicare AllowedAmount | 5605.27 |
| Total Drug Medicare PaymentAmount | 3928.75 |
| Total Drug Medicare Standardized Payment Amount | 3928.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 158 |
| Number Of Medical Services | 3942 |
| Number Of Medicare Beneficiaries With Medical Services | 2577 |
| Total Medical Submitted Charge Amount | 2556022 |
| Total Medical Medicare Allowed Amount | 237386.85 |
| Total Medical Medicare Payment Amount | 183641 |
| Total Medical Medicare Standardized Payment Amount | 193432.58 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 433 |
| Number Of Beneficiaries Age 65 to 74 | 1064 |
| Number Of Beneficiaries Age 75 to 84 | 700 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1626 |
| Number Of Male Beneficiaries | 952 |
| Number Of Non Hispanic White Beneficiaries | 2424 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2029 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 549 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2007 |