| National Provider Identifier [NPI]: | 1255336897 |
| Last Name Of The Provider | HAWN |
| First Name Of The Provider | VICKI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2116 CRAIG RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAU CLAIRE |
| Zip Code Of The Provider | 547016149 |
| 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 | 85 |
| Number Of Services | 3137 |
| Number Of Medicare Beneficiaries | 2353 |
| Total Submitted Charge Amount | 327688.3 |
| Total Medicare Allowed Amount | 57539.22 |
| Total Medicare Payment Amount | 40298.12 |
| Total Medicare Standardized Payment Amount | 42513.95 |
| 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 | 85 |
| Number Of Medical Services | 3137 |
| Number Of Medicare Beneficiaries With Medical Services | 2353 |
| Total Medical Submitted Charge Amount | 327688.3 |
| Total Medical Medicare Allowed Amount | 57539.22 |
| Total Medical Medicare Payment Amount | 40298.12 |
| Total Medical Medicare Standardized Payment Amount | 42513.95 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 492 |
| Number Of Beneficiaries Age 65 to 74 | 918 |
| Number Of Beneficiaries Age 75 to 84 | 645 |
| Number Of Beneficiaries Age Greater 84 | 298 |
| Number Of Female Beneficiaries | 1405 |
| Number Of Male Beneficiaries | 948 |
| Number Of Non Hispanic White Beneficiaries | 2263 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 22 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 722 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.4938 |