| National Provider Identifier [NPI]: | 1609822873 |
| Last Name Of The Provider | HOLTHAUS |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1010 4TH ST SW |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MASON CITY |
| Zip Code Of The Provider | 504012857 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 234 |
| Number Of Services | 2768 |
| Number Of Medicare Beneficiaries | 1419 |
| Total Submitted Charge Amount | 514239.68 |
| Total Medicare Allowed Amount | 175688.87 |
| Total Medicare Payment Amount | 136245.66 |
| Total Medicare Standardized Payment Amount | 145632.31 |
| 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 | 234 |
| Number Of Medical Services | 2768 |
| Number Of Medicare Beneficiaries With Medical Services | 1419 |
| Total Medical Submitted Charge Amount | 514239.68 |
| Total Medical Medicare Allowed Amount | 175688.87 |
| Total Medical Medicare Payment Amount | 136245.66 |
| Total Medical Medicare Standardized Payment Amount | 145632.31 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 157 |
| Number Of Beneficiaries Age 65 to 74 | 507 |
| Number Of Beneficiaries Age 75 to 84 | 507 |
| Number Of Beneficiaries Age Greater 84 | 248 |
| Number Of Female Beneficiaries | 772 |
| Number Of Male Beneficiaries | 647 |
| Number Of Non Hispanic White Beneficiaries | 1390 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 241 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5365 |