| National Provider Identifier [NPI]: | 1154355071 |
| Last Name Of The Provider | GADWOOD |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3264 N EVERGREEN DR NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495259746 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 2216 |
| Number Of Medicare Beneficiaries | 1623 |
| Total Submitted Charge Amount | 409743 |
| Total Medicare Allowed Amount | 91521.88 |
| Total Medicare Payment Amount | 68036.55 |
| Total Medicare Standardized Payment Amount | 71303.33 |
| 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 | 96 |
| Number Of Medical Services | 2216 |
| Number Of Medicare Beneficiaries With Medical Services | 1623 |
| Total Medical Submitted Charge Amount | 409743 |
| Total Medical Medicare Allowed Amount | 91521.88 |
| Total Medical Medicare Payment Amount | 68036.55 |
| Total Medical Medicare Standardized Payment Amount | 71303.33 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 479 |
| Number Of Beneficiaries Age 65 to 74 | 518 |
| Number Of Beneficiaries Age 75 to 84 | 407 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 993 |
| Number Of Male Beneficiaries | 630 |
| Number Of Non Hispanic White Beneficiaries | 1392 |
| Number Of Black or African American Beneficiaries | 153 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 506 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.676 |