| National Provider Identifier [NPI]: | 1215953997 |
| Last Name Of The Provider | RYAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 E 3RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DULUTH |
| Zip Code Of The Provider | 558051951 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 5691 |
| Number Of Medicare Beneficiaries | 3136 |
| Total Submitted Charge Amount | 611049 |
| Total Medicare Allowed Amount | 131624.02 |
| Total Medicare Payment Amount | 102364.63 |
| Total Medicare Standardized Payment Amount | 105841.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 529 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 7150 |
| Total Drug Medicare AllowedAmount | 967.17 |
| Total Drug Medicare PaymentAmount | 758.23 |
| Total Drug Medicare Standardized Payment Amount | 758.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 5162 |
| Number Of Medicare Beneficiaries With Medical Services | 3115 |
| Total Medical Submitted Charge Amount | 603899 |
| Total Medical Medicare Allowed Amount | 130656.85 |
| Total Medical Medicare Payment Amount | 101606.4 |
| Total Medical Medicare Standardized Payment Amount | 105083.09 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 947 |
| Number Of Beneficiaries Age 65 to 74 | 1073 |
| Number Of Beneficiaries Age 75 to 84 | 714 |
| Number Of Beneficiaries Age Greater 84 | 402 |
| Number Of Female Beneficiaries | 1970 |
| Number Of Male Beneficiaries | 1166 |
| Number Of Non Hispanic White Beneficiaries | 2903 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | 126 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2030 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1106 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3644 |