| National Provider Identifier [NPI]: | 1003985771 |
| Last Name Of The Provider | TODD |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 PALOMINO LANE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064894 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 5132 |
| Number Of Medicare Beneficiaries | 3335 |
| Total Submitted Charge Amount | 457652 |
| Total Medicare Allowed Amount | 171462.63 |
| Total Medicare Payment Amount | 127581.48 |
| Total Medicare Standardized Payment Amount | 131582.68 |
| 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 | 150 |
| Number Of Medical Services | 5132 |
| Number Of Medicare Beneficiaries With Medical Services | 3335 |
| Total Medical Submitted Charge Amount | 457652 |
| Total Medical Medicare Allowed Amount | 171462.63 |
| Total Medical Medicare Payment Amount | 127581.48 |
| Total Medical Medicare Standardized Payment Amount | 131582.68 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 731 |
| Number Of Beneficiaries Age 65 to 74 | 1259 |
| Number Of Beneficiaries Age 75 to 84 | 936 |
| Number Of Beneficiaries Age Greater 84 | 409 |
| Number Of Female Beneficiaries | 2097 |
| Number Of Male Beneficiaries | 1238 |
| Number Of Non Hispanic White Beneficiaries | 3025 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 917 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5928 |