| National Provider Identifier [NPI]: | 1588779441 |
| Last Name Of The Provider | KINTZINGER |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12550 W MORELAND RD # 67 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAYWARD |
| Zip Code Of The Provider | 548434525 |
| 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 | 146 |
| Number Of Services | 14177 |
| Number Of Medicare Beneficiaries | 2689 |
| Total Submitted Charge Amount | 1689373 |
| Total Medicare Allowed Amount | 219252.68 |
| Total Medicare Payment Amount | 168345.23 |
| Total Medicare Standardized Payment Amount | 176452.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 10155 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 12089.4 |
| Total Drug Medicare AllowedAmount | 2622.48 |
| Total Drug Medicare PaymentAmount | 2037.37 |
| Total Drug Medicare Standardized Payment Amount | 2037.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 144 |
| Number Of Medical Services | 4022 |
| Number Of Medicare Beneficiaries With Medical Services | 2686 |
| Total Medical Submitted Charge Amount | 1677283.6 |
| Total Medical Medicare Allowed Amount | 216630.2 |
| Total Medical Medicare Payment Amount | 166307.86 |
| Total Medical Medicare Standardized Payment Amount | 174414.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 422 |
| Number Of Beneficiaries Age 65 to 74 | 1168 |
| Number Of Beneficiaries Age 75 to 84 | 813 |
| Number Of Beneficiaries Age Greater 84 | 286 |
| Number Of Female Beneficiaries | 1652 |
| Number Of Male Beneficiaries | 1037 |
| Number Of Non Hispanic White Beneficiaries | 2583 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 40 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 563 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3303 |