| National Provider Identifier [NPI]: | 1114157369 |
| Last Name Of The Provider | SVIGGUM |
| First Name Of The Provider | ERIK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 BELLINGER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAU CLAIRE |
| Zip Code Of The Provider | 547035222 |
| 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 | 52 |
| Number Of Services | 2271 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 81047.41 |
| Total Medicare Allowed Amount | 52347.26 |
| Total Medicare Payment Amount | 39911.59 |
| Total Medicare Standardized Payment Amount | 44544.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1982 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 3078.07 |
| Total Drug Medicare AllowedAmount | 2774.04 |
| Total Drug Medicare PaymentAmount | 2143.4 |
| Total Drug Medicare Standardized Payment Amount | 2143.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 289 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 77969.34 |
| Total Medical Medicare Allowed Amount | 49573.22 |
| Total Medical Medicare Payment Amount | 37768.19 |
| Total Medical Medicare Standardized Payment Amount | 42401.4 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 218 |
| 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 | 194 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7458 |