| National Provider Identifier [NPI]: | 1366429466 |
| Last Name Of The Provider | MARDIS |
| First Name Of The Provider | ARTHUR |
| 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 | 1600 MORGAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KEOKUK |
| Zip Code Of The Provider | 526323456 |
| 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 | 118 |
| Number Of Services | 4751 |
| Number Of Medicare Beneficiaries | 1755 |
| Total Submitted Charge Amount | 678998 |
| Total Medicare Allowed Amount | 105092.59 |
| Total Medicare Payment Amount | 80563.89 |
| Total Medicare Standardized Payment Amount | 85519.84 |
| 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 | 118 |
| Number Of Medical Services | 4751 |
| Number Of Medicare Beneficiaries With Medical Services | 1755 |
| Total Medical Submitted Charge Amount | 678998 |
| Total Medical Medicare Allowed Amount | 105092.59 |
| Total Medical Medicare Payment Amount | 80563.89 |
| Total Medical Medicare Standardized Payment Amount | 85519.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 609 |
| Number Of Beneficiaries Age 75 to 84 | 520 |
| Number Of Beneficiaries Age Greater 84 | 303 |
| Number Of Female Beneficiaries | 1029 |
| Number Of Male Beneficiaries | 726 |
| Number Of Non Hispanic White Beneficiaries | 1703 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1230 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 525 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2674 |