| National Provider Identifier [NPI]: | 1548249246 |
| Last Name Of The Provider | MYERS |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 403 S OAK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE CITY |
| Zip Code Of The Provider | 550411739 |
| 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 | 210 |
| Number Of Services | 9571 |
| Number Of Medicare Beneficiaries | 4835 |
| Total Submitted Charge Amount | 839179.24 |
| Total Medicare Allowed Amount | 279849.95 |
| Total Medicare Payment Amount | 217766.01 |
| Total Medicare Standardized Payment Amount | 222720.49 |
| 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 | 210 |
| Number Of Medical Services | 9571 |
| Number Of Medicare Beneficiaries With Medical Services | 4835 |
| Total Medical Submitted Charge Amount | 839179.24 |
| Total Medical Medicare Allowed Amount | 279849.95 |
| Total Medical Medicare Payment Amount | 217766.01 |
| Total Medical Medicare Standardized Payment Amount | 222720.49 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 855 |
| Number Of Beneficiaries Age 65 to 74 | 1758 |
| Number Of Beneficiaries Age 75 to 84 | 1447 |
| Number Of Beneficiaries Age Greater 84 | 775 |
| Number Of Female Beneficiaries | 2890 |
| Number Of Male Beneficiaries | 1945 |
| Number Of Non Hispanic White Beneficiaries | 4306 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 269 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3554 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1281 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5948 |