| National Provider Identifier [NPI]: | 1215958178 |
| Last Name Of The Provider | AXTELL |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2875 S 171ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BERLIN |
| Zip Code Of The Provider | 531513511 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 4613 |
| Number Of Medicare Beneficiaries | 3376 |
| Total Submitted Charge Amount | 1293564 |
| Total Medicare Allowed Amount | 145487.99 |
| Total Medicare Payment Amount | 108394.03 |
| Total Medicare Standardized Payment Amount | 115116 |
| 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 | 168 |
| Number Of Medical Services | 4613 |
| Number Of Medicare Beneficiaries With Medical Services | 3376 |
| Total Medical Submitted Charge Amount | 1293564 |
| Total Medical Medicare Allowed Amount | 145487.99 |
| Total Medical Medicare Payment Amount | 108394.03 |
| Total Medical Medicare Standardized Payment Amount | 115116 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 603 |
| Number Of Beneficiaries Age 65 to 74 | 1093 |
| Number Of Beneficiaries Age 75 to 84 | 1026 |
| Number Of Beneficiaries Age Greater 84 | 654 |
| Number Of Female Beneficiaries | 2111 |
| Number Of Male Beneficiaries | 1265 |
| Number Of Non Hispanic White Beneficiaries | 2947 |
| Number Of Black or African American Beneficiaries | 237 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 112 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 873 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.701 |