| National Provider Identifier [NPI]: | 1770531394 |
| Last Name Of The Provider | LIPKOWITZ |
| First Name Of The Provider | ALLAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11126 N WYNGATE TRCE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEQUON |
| Zip Code Of The Provider | 530925871 |
| 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 | 217 |
| Number Of Services | 2642 |
| Number Of Medicare Beneficiaries | 1338 |
| Total Submitted Charge Amount | 377158.02 |
| Total Medicare Allowed Amount | 96739.46 |
| Total Medicare Payment Amount | 76500.29 |
| Total Medicare Standardized Payment Amount | 75557.99 |
| 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 | 217 |
| Number Of Medical Services | 2642 |
| Number Of Medicare Beneficiaries With Medical Services | 1338 |
| Total Medical Submitted Charge Amount | 377158.02 |
| Total Medical Medicare Allowed Amount | 96739.46 |
| Total Medical Medicare Payment Amount | 76500.29 |
| Total Medical Medicare Standardized Payment Amount | 75557.99 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 586 |
| Number Of Beneficiaries Age 75 to 84 | 383 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 900 |
| Number Of Male Beneficiaries | 438 |
| Number Of Non Hispanic White Beneficiaries | 894 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 350 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 850 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 488 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7889 |