| National Provider Identifier [NPI]: | 1154307395 |
| Last Name Of The Provider | GLANTZ |
| First Name Of The Provider | JANEL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 WEST AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA CROSSE |
| Zip Code Of The Provider | 546014783 |
| 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 | 160 |
| Number Of Services | 4459 |
| Number Of Medicare Beneficiaries | 2319 |
| Total Submitted Charge Amount | 766950.54 |
| Total Medicare Allowed Amount | 127762.69 |
| Total Medicare Payment Amount | 101558.12 |
| Total Medicare Standardized Payment Amount | 106612.79 |
| 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 | 160 |
| Number Of Medical Services | 4459 |
| Number Of Medicare Beneficiaries With Medical Services | 2319 |
| Total Medical Submitted Charge Amount | 766950.54 |
| Total Medical Medicare Allowed Amount | 127762.69 |
| Total Medical Medicare Payment Amount | 101558.12 |
| Total Medical Medicare Standardized Payment Amount | 106612.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 426 |
| Number Of Beneficiaries Age 65 to 74 | 1037 |
| Number Of Beneficiaries Age 75 to 84 | 555 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 1647 |
| Number Of Male Beneficiaries | 672 |
| Number Of Non Hispanic White Beneficiaries | 2248 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1679 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 640 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1748 |