| National Provider Identifier [NPI]: | 1558472480 |
| Last Name Of The Provider | ROMANG |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 WESTHILL DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WAUSAU |
| Zip Code Of The Provider | 544014705 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 541 |
| Number Of Medicare Beneficiaries | 205 |
| Total Submitted Charge Amount | 177468.98 |
| Total Medicare Allowed Amount | 55660.3 |
| Total Medicare Payment Amount | 40387.22 |
| Total Medicare Standardized Payment Amount | 42756.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1169 |
| Total Drug Medicare AllowedAmount | 239.9 |
| Total Drug Medicare PaymentAmount | 188.11 |
| Total Drug Medicare Standardized Payment Amount | 188.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 499 |
| Number Of Medicare Beneficiaries With Medical Services | 205 |
| Total Medical Submitted Charge Amount | 176299.98 |
| Total Medical Medicare Allowed Amount | 55420.4 |
| Total Medical Medicare Payment Amount | 40199.11 |
| Total Medical Medicare Standardized Payment Amount | 42568.48 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 119 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1781 |