| National Provider Identifier [NPI]: | 1588673412 |
| Last Name Of The Provider | MAXWELL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| 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 | 96 |
| Number Of Services | 12645 |
| Number Of Medicare Beneficiaries | 2101 |
| Total Submitted Charge Amount | 225349.4 |
| Total Medicare Allowed Amount | 168897.02 |
| Total Medicare Payment Amount | 139884.94 |
| Total Medicare Standardized Payment Amount | 150844.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 9108 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 2607.53 |
| Total Drug Medicare AllowedAmount | 1925.22 |
| Total Drug Medicare PaymentAmount | 1363.12 |
| Total Drug Medicare Standardized Payment Amount | 1363.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 3537 |
| Number Of Medicare Beneficiaries With Medical Services | 2100 |
| Total Medical Submitted Charge Amount | 222741.87 |
| Total Medical Medicare Allowed Amount | 166971.8 |
| Total Medical Medicare Payment Amount | 138521.82 |
| Total Medical Medicare Standardized Payment Amount | 149481.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 311 |
| Number Of Beneficiaries Age 65 to 74 | 884 |
| Number Of Beneficiaries Age 75 to 84 | 626 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 1323 |
| Number Of Male Beneficiaries | 778 |
| Number Of Non Hispanic White Beneficiaries | 2006 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1782 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 319 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.494 |