| National Provider Identifier [NPI]: | 1679553564 |
| Last Name Of The Provider | DENHOLM |
| First Name Of The Provider | TODD |
| 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 | 268 |
| Number Of Services | 6300 |
| Number Of Medicare Beneficiaries | 2575 |
| Total Submitted Charge Amount | 1506371.35 |
| Total Medicare Allowed Amount | 181312.04 |
| Total Medicare Payment Amount | 142314.46 |
| Total Medicare Standardized Payment Amount | 148530.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2184 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 2676 |
| Total Drug Medicare AllowedAmount | 639.58 |
| Total Drug Medicare PaymentAmount | 455.26 |
| Total Drug Medicare Standardized Payment Amount | 455.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 262 |
| Number Of Medical Services | 4116 |
| Number Of Medicare Beneficiaries With Medical Services | 2575 |
| Total Medical Submitted Charge Amount | 1503695.35 |
| Total Medical Medicare Allowed Amount | 180672.46 |
| Total Medical Medicare Payment Amount | 141859.2 |
| Total Medical Medicare Standardized Payment Amount | 148075.65 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 405 |
| Number Of Beneficiaries Age 65 to 74 | 978 |
| Number Of Beneficiaries Age 75 to 84 | 783 |
| Number Of Beneficiaries Age Greater 84 | 409 |
| Number Of Female Beneficiaries | 1561 |
| Number Of Male Beneficiaries | 1014 |
| Number Of Non Hispanic White Beneficiaries | 2466 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1995 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 580 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3896 |