| National Provider Identifier [NPI]: | 1255340162 |
| Last Name Of The Provider | HACKWORTH |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 WESTHILL DR |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | WAUSAU |
| Zip Code Of The Provider | 544014705 |
| 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 | 184 |
| Number Of Services | 3211 |
| Number Of Medicare Beneficiaries | 1955 |
| Total Submitted Charge Amount | 676515 |
| Total Medicare Allowed Amount | 94364.77 |
| Total Medicare Payment Amount | 71190.51 |
| Total Medicare Standardized Payment Amount | 75027.31 |
| 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 | 184 |
| Number Of Medical Services | 3211 |
| Number Of Medicare Beneficiaries With Medical Services | 1955 |
| Total Medical Submitted Charge Amount | 676515 |
| Total Medical Medicare Allowed Amount | 94364.77 |
| Total Medical Medicare Payment Amount | 71190.51 |
| Total Medical Medicare Standardized Payment Amount | 75027.31 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 333 |
| Number Of Beneficiaries Age 65 to 74 | 722 |
| Number Of Beneficiaries Age 75 to 84 | 581 |
| Number Of Beneficiaries Age Greater 84 | 319 |
| Number Of Female Beneficiaries | 1034 |
| Number Of Male Beneficiaries | 921 |
| Number Of Non Hispanic White Beneficiaries | 1844 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 520 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6396 |