| National Provider Identifier [NPI]: | 1295995926 |
| Last Name Of The Provider | MEISAMY |
| First Name Of The Provider | SINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537920001 |
| 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 | 114 |
| Number Of Services | 1977 |
| Number Of Medicare Beneficiaries | 1206 |
| Total Submitted Charge Amount | 312186.75 |
| Total Medicare Allowed Amount | 79318.73 |
| Total Medicare Payment Amount | 61013.56 |
| Total Medicare Standardized Payment Amount | 63174.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1240 |
| Total Drug Medicare AllowedAmount | 69.08 |
| Total Drug Medicare PaymentAmount | 53.94 |
| Total Drug Medicare Standardized Payment Amount | 53.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 1946 |
| Number Of Medicare Beneficiaries With Medical Services | 1206 |
| Total Medical Submitted Charge Amount | 310946.75 |
| Total Medical Medicare Allowed Amount | 79249.65 |
| Total Medical Medicare Payment Amount | 60959.62 |
| Total Medical Medicare Standardized Payment Amount | 63120.21 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 324 |
| Number Of Beneficiaries Age 65 to 74 | 375 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 207 |
| Number Of Female Beneficiaries | 703 |
| Number Of Male Beneficiaries | 503 |
| Number Of Non Hispanic White Beneficiaries | 620 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 483 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 787 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 419 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2842 |