| National Provider Identifier [NPI]: | 1801837349 |
| Last Name Of The Provider | STEELY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 NICOLLET AVE |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554032420 |
| 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 | 65 |
| Number Of Services | 2006 |
| Number Of Medicare Beneficiaries | 971 |
| Total Submitted Charge Amount | 436990.97 |
| Total Medicare Allowed Amount | 122375.75 |
| Total Medicare Payment Amount | 94297.85 |
| Total Medicare Standardized Payment Amount | 99188.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 625 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 2657.7 |
| Total Drug Medicare AllowedAmount | 1020.16 |
| Total Drug Medicare PaymentAmount | 768.95 |
| Total Drug Medicare Standardized Payment Amount | 768.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 1381 |
| Number Of Medicare Beneficiaries With Medical Services | 971 |
| Total Medical Submitted Charge Amount | 434333.27 |
| Total Medical Medicare Allowed Amount | 121355.59 |
| Total Medical Medicare Payment Amount | 93528.9 |
| Total Medical Medicare Standardized Payment Amount | 98419.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 554 |
| Number Of Male Beneficiaries | 417 |
| Number Of Non Hispanic White Beneficiaries | 879 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 705 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 266 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.338 |