| National Provider Identifier [NPI]: | 1548451073 |
| Last Name Of The Provider | NASCENE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 DELAWARE ST SE |
| Street Address 2 Of The Provider | B-211 MAYO BUILDING - DEPARTMENT OF RADIOLOGY |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554550341 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 8630 |
| Number Of Medicare Beneficiaries | 721 |
| Total Submitted Charge Amount | 767070.2 |
| Total Medicare Allowed Amount | 118403.14 |
| Total Medicare Payment Amount | 90667.28 |
| Total Medicare Standardized Payment Amount | 95101.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7455 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 4800.2 |
| Total Drug Medicare AllowedAmount | 2644.64 |
| Total Drug Medicare PaymentAmount | 2055.39 |
| Total Drug Medicare Standardized Payment Amount | 2055.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 1175 |
| Number Of Medicare Beneficiaries With Medical Services | 721 |
| Total Medical Submitted Charge Amount | 762270 |
| Total Medical Medicare Allowed Amount | 115758.5 |
| Total Medical Medicare Payment Amount | 88611.89 |
| Total Medical Medicare Standardized Payment Amount | 93046.19 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 332 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 366 |
| Number Of Male Beneficiaries | 355 |
| Number Of Non Hispanic White Beneficiaries | 590 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 314 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2167 |