| National Provider Identifier [NPI]: | 1821099748 |
| Last Name Of The Provider | WOOLNER |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 OAKDALE AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROBBINSDALE |
| Zip Code Of The Provider | 554222926 |
| 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 | 173 |
| Number Of Services | 5078 |
| Number Of Medicare Beneficiaries | 1709 |
| Total Submitted Charge Amount | 393710 |
| Total Medicare Allowed Amount | 118332.95 |
| Total Medicare Payment Amount | 89834.04 |
| Total Medicare Standardized Payment Amount | 93067.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2446 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 2697 |
| Total Drug Medicare AllowedAmount | 586.8 |
| Total Drug Medicare PaymentAmount | 412.58 |
| Total Drug Medicare Standardized Payment Amount | 412.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 2632 |
| Number Of Medicare Beneficiaries With Medical Services | 1709 |
| Total Medical Submitted Charge Amount | 391013 |
| Total Medical Medicare Allowed Amount | 117746.15 |
| Total Medical Medicare Payment Amount | 89421.46 |
| Total Medical Medicare Standardized Payment Amount | 92654.46 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 557 |
| Number Of Beneficiaries Age 65 to 74 | 472 |
| Number Of Beneficiaries Age 75 to 84 | 415 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 1098 |
| Number Of Male Beneficiaries | 611 |
| Number Of Non Hispanic White Beneficiaries | 1420 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1077 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 632 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6681 |