| National Provider Identifier [NPI]: | 1811043037 |
| Last Name Of The Provider | MUSACK |
| First Name Of The Provider | RANDY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N OAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARSHFIELD |
| Zip Code Of The Provider | 544495703 |
| 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 | 130 |
| Number Of Services | 6952 |
| Number Of Medicare Beneficiaries | 2733 |
| Total Submitted Charge Amount | 1005144.2 |
| Total Medicare Allowed Amount | 141625.22 |
| Total Medicare Payment Amount | 108704.51 |
| Total Medicare Standardized Payment Amount | 113103.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2456 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 2836.7 |
| Total Drug Medicare AllowedAmount | 545.22 |
| Total Drug Medicare PaymentAmount | 423.72 |
| Total Drug Medicare Standardized Payment Amount | 423.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 4496 |
| Number Of Medicare Beneficiaries With Medical Services | 2731 |
| Total Medical Submitted Charge Amount | 1002307.5 |
| Total Medical Medicare Allowed Amount | 141080 |
| Total Medical Medicare Payment Amount | 108280.79 |
| Total Medical Medicare Standardized Payment Amount | 112679.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 615 |
| Number Of Beneficiaries Age 65 to 74 | 920 |
| Number Of Beneficiaries Age 75 to 84 | 761 |
| Number Of Beneficiaries Age Greater 84 | 437 |
| Number Of Female Beneficiaries | 1533 |
| Number Of Male Beneficiaries | 1200 |
| Number Of Non Hispanic White Beneficiaries | 2595 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 74 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1762 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 971 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.803 |