| National Provider Identifier [NPI]: | 1801873658 |
| Last Name Of The Provider | HARTMAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| 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 | 40 |
| Number Of Services | 28417 |
| Number Of Medicare Beneficiaries | 1928 |
| Total Submitted Charge Amount | 272499.87 |
| Total Medicare Allowed Amount | 155416.72 |
| Total Medicare Payment Amount | 114118.61 |
| Total Medicare Standardized Payment Amount | 136329.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 25469 |
| Number Of Medicare Beneficiaries With Drug Services | 191 |
| Total Drug Submitted ChargeAmount | 6748.15 |
| Total Drug Medicare AllowedAmount | 4500.95 |
| Total Drug Medicare PaymentAmount | 2980.91 |
| Total Drug Medicare Standardized Payment Amount | 2980.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2948 |
| Number Of Medicare Beneficiaries With Medical Services | 1909 |
| Total Medical Submitted Charge Amount | 265751.72 |
| Total Medical Medicare Allowed Amount | 150915.77 |
| Total Medical Medicare Payment Amount | 111137.7 |
| Total Medical Medicare Standardized Payment Amount | 133348.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 255 |
| Number Of Beneficiaries Age 65 to 74 | 827 |
| Number Of Beneficiaries Age 75 to 84 | 659 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 957 |
| Number Of Male Beneficiaries | 971 |
| Number Of Non Hispanic White Beneficiaries | 1829 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1745 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 183 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6369 |