| National Provider Identifier [NPI]: | 1871571125 |
| Last Name Of The Provider | BLOCK |
| First Name Of The Provider | NATHAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| 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 | 162 |
| Number Of Services | 4739 |
| Number Of Medicare Beneficiaries | 2315 |
| Total Submitted Charge Amount | 495735.71 |
| Total Medicare Allowed Amount | 144541.14 |
| Total Medicare Payment Amount | 107604.18 |
| Total Medicare Standardized Payment Amount | 111071.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1450 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 13844 |
| Total Drug Medicare AllowedAmount | 1201.79 |
| Total Drug Medicare PaymentAmount | 926.56 |
| Total Drug Medicare Standardized Payment Amount | 926.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 156 |
| Number Of Medical Services | 3289 |
| Number Of Medicare Beneficiaries With Medical Services | 2312 |
| Total Medical Submitted Charge Amount | 481891.71 |
| Total Medical Medicare Allowed Amount | 143339.35 |
| Total Medical Medicare Payment Amount | 106677.62 |
| Total Medical Medicare Standardized Payment Amount | 110144.96 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 669 |
| Number Of Beneficiaries Age 65 to 74 | 695 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 1372 |
| Number Of Male Beneficiaries | 943 |
| Number Of Non Hispanic White Beneficiaries | 1976 |
| Number Of Black or African American Beneficiaries | 169 |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 750 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6774 |