| National Provider Identifier [NPI]: | 1982708061 |
| Last Name Of The Provider | RISA |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| 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 | 54449 |
| 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 | 109 |
| Number Of Services | 5236 |
| Number Of Medicare Beneficiaries | 1911 |
| Total Submitted Charge Amount | 1750533.71 |
| Total Medicare Allowed Amount | 156091.25 |
| Total Medicare Payment Amount | 114751.65 |
| Total Medicare Standardized Payment Amount | 122089.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2638 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 9389.5 |
| Total Drug Medicare AllowedAmount | 2191.07 |
| Total Drug Medicare PaymentAmount | 1706.73 |
| Total Drug Medicare Standardized Payment Amount | 1706.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 2598 |
| Number Of Medicare Beneficiaries With Medical Services | 1911 |
| Total Medical Submitted Charge Amount | 1741144.21 |
| Total Medical Medicare Allowed Amount | 153900.18 |
| Total Medical Medicare Payment Amount | 113044.92 |
| Total Medical Medicare Standardized Payment Amount | 120382.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 450 |
| Number Of Beneficiaries Age 65 to 74 | 700 |
| Number Of Beneficiaries Age 75 to 84 | 549 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 1070 |
| Number Of Male Beneficiaries | 841 |
| Number Of Non Hispanic White Beneficiaries | 1836 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 29 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 601 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4275 |