| National Provider Identifier [NPI]: | 1184836199 |
| Last Name Of The Provider | JEPPERSON |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1325 S CLIFF AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SIOUX FALLS |
| Zip Code Of The Provider | 571051007 |
| State Code Of The Provider | SD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 4582 |
| Number Of Medicare Beneficiaries | 3074 |
| Total Submitted Charge Amount | 115310.53 |
| Total Medicare Allowed Amount | 106293.58 |
| Total Medicare Payment Amount | 78789.66 |
| Total Medicare Standardized Payment Amount | 84936.5 |
| 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 | 123 |
| Number Of Medical Services | 4582 |
| Number Of Medicare Beneficiaries With Medical Services | 3074 |
| Total Medical Submitted Charge Amount | 115310.53 |
| Total Medical Medicare Allowed Amount | 106293.58 |
| Total Medical Medicare Payment Amount | 78789.66 |
| Total Medical Medicare Standardized Payment Amount | 84936.5 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 450 |
| Number Of Beneficiaries Age 65 to 74 | 1071 |
| Number Of Beneficiaries Age 75 to 84 | 956 |
| Number Of Beneficiaries Age Greater 84 | 597 |
| Number Of Female Beneficiaries | 1891 |
| Number Of Male Beneficiaries | 1183 |
| Number Of Non Hispanic White Beneficiaries | 2959 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 52 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 620 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4915 |