| National Provider Identifier [NPI]: | 1548262744 |
| Last Name Of The Provider | PLAGMAN |
| First Name Of The Provider | EWA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1836 SOUTH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA CROSSE |
| Zip Code Of The Provider | 546015429 |
| 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 | 100 |
| Number Of Services | 5529 |
| Number Of Medicare Beneficiaries | 2180 |
| Total Submitted Charge Amount | 539835.2 |
| Total Medicare Allowed Amount | 73238.58 |
| Total Medicare Payment Amount | 59578.38 |
| Total Medicare Standardized Payment Amount | 62091.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2860 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2399.75 |
| Total Drug Medicare AllowedAmount | 669.37 |
| Total Drug Medicare PaymentAmount | 470.49 |
| Total Drug Medicare Standardized Payment Amount | 470.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 2669 |
| Number Of Medicare Beneficiaries With Medical Services | 2166 |
| Total Medical Submitted Charge Amount | 537435.45 |
| Total Medical Medicare Allowed Amount | 72569.21 |
| Total Medical Medicare Payment Amount | 59107.89 |
| Total Medical Medicare Standardized Payment Amount | 61620.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 336 |
| Number Of Beneficiaries Age 65 to 74 | 909 |
| Number Of Beneficiaries Age 75 to 84 | 613 |
| Number Of Beneficiaries Age Greater 84 | 322 |
| Number Of Female Beneficiaries | 1577 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 2124 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1635 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 545 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2186 |