| National Provider Identifier [NPI]: | 1689660276 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7505 METRO BLVD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554393081 |
| 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 | 92 |
| Number Of Services | 3237 |
| Number Of Medicare Beneficiaries | 1567 |
| Total Submitted Charge Amount | 429526 |
| Total Medicare Allowed Amount | 107100.23 |
| Total Medicare Payment Amount | 82343.86 |
| Total Medicare Standardized Payment Amount | 80865.84 |
| 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 | 92 |
| Number Of Medical Services | 3237 |
| Number Of Medicare Beneficiaries With Medical Services | 1567 |
| Total Medical Submitted Charge Amount | 429526 |
| Total Medical Medicare Allowed Amount | 107100.23 |
| Total Medical Medicare Payment Amount | 82343.86 |
| Total Medical Medicare Standardized Payment Amount | 80865.84 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 515 |
| Number Of Beneficiaries Age 65 to 74 | 481 |
| Number Of Beneficiaries Age 75 to 84 | 359 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 802 |
| Number Of Male Beneficiaries | 765 |
| Number Of Non Hispanic White Beneficiaries | 721 |
| Number Of Black or African American Beneficiaries | 793 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 901 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 666 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.5706 |