| National Provider Identifier [NPI]: | 1386614717 |
| Last Name Of The Provider | BUETOW |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | DDEAMC, DEPARTMENT OF RADIOLOGY |
| Street Address 2 Of The Provider | 300 HOSPITAL RD. |
| City Of The Provider | FT GORDON |
| Zip Code Of The Provider | 30905 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 16882 |
| Number Of Medicare Beneficiaries | 2591 |
| Total Submitted Charge Amount | 1477969.4 |
| Total Medicare Allowed Amount | 269103.89 |
| Total Medicare Payment Amount | 208861.89 |
| Total Medicare Standardized Payment Amount | 210505.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12810 |
| Number Of Medicare Beneficiaries With Drug Services | 159 |
| Total Drug Submitted ChargeAmount | 14712.1 |
| Total Drug Medicare AllowedAmount | 3420.28 |
| Total Drug Medicare PaymentAmount | 2681.38 |
| Total Drug Medicare Standardized Payment Amount | 2681.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 4072 |
| Number Of Medicare Beneficiaries With Medical Services | 2590 |
| Total Medical Submitted Charge Amount | 1463257.3 |
| Total Medical Medicare Allowed Amount | 265683.61 |
| Total Medical Medicare Payment Amount | 206180.51 |
| Total Medical Medicare Standardized Payment Amount | 207823.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 430 |
| Number Of Beneficiaries Age 65 to 74 | 975 |
| Number Of Beneficiaries Age 75 to 84 | 795 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 1574 |
| Number Of Male Beneficiaries | 1017 |
| Number Of Non Hispanic White Beneficiaries | 2333 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 97 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1963 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 628 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2957 |