| National Provider Identifier [NPI]: | 1770563678 |
| Last Name Of The Provider | CRUMMY |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| 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 | 242 |
| Number Of Services | 4608 |
| Number Of Medicare Beneficiaries | 1601 |
| Total Submitted Charge Amount | 1043510.06 |
| Total Medicare Allowed Amount | 122730.52 |
| Total Medicare Payment Amount | 95669.08 |
| Total Medicare Standardized Payment Amount | 99698.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2113 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2319.5 |
| Total Drug Medicare AllowedAmount | 626.03 |
| Total Drug Medicare PaymentAmount | 428.24 |
| Total Drug Medicare Standardized Payment Amount | 428.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 237 |
| Number Of Medical Services | 2495 |
| Number Of Medicare Beneficiaries With Medical Services | 1601 |
| Total Medical Submitted Charge Amount | 1041190.56 |
| Total Medical Medicare Allowed Amount | 122104.49 |
| Total Medical Medicare Payment Amount | 95240.84 |
| Total Medical Medicare Standardized Payment Amount | 99270.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 272 |
| Number Of Beneficiaries Age 65 to 74 | 554 |
| Number Of Beneficiaries Age 75 to 84 | 457 |
| Number Of Beneficiaries Age Greater 84 | 318 |
| Number Of Female Beneficiaries | 979 |
| Number Of Male Beneficiaries | 622 |
| Number Of Non Hispanic White Beneficiaries | 1529 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 403 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.551 |