| National Provider Identifier [NPI]: | 1447296744 |
| Last Name Of The Provider | PANZER |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 E ENTERPRISE AVE |
| Street Address 2 Of The Provider | UNIT C |
| City Of The Provider | APPLETON |
| Zip Code Of The Provider | 54913 |
| 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 | 110 |
| Number Of Services | 1807 |
| Number Of Medicare Beneficiaries | 1208 |
| Total Submitted Charge Amount | 317776 |
| Total Medicare Allowed Amount | 38297.73 |
| Total Medicare Payment Amount | 29980.74 |
| Total Medicare Standardized Payment Amount | 31245.19 |
| 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 | 110 |
| Number Of Medical Services | 1807 |
| Number Of Medicare Beneficiaries With Medical Services | 1208 |
| Total Medical Submitted Charge Amount | 317776 |
| Total Medical Medicare Allowed Amount | 38297.73 |
| Total Medical Medicare Payment Amount | 29980.74 |
| Total Medical Medicare Standardized Payment Amount | 31245.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 217 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 199 |
| Number Of Female Beneficiaries | 791 |
| Number Of Male Beneficiaries | 417 |
| Number Of Non Hispanic White Beneficiaries | 1119 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 43 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 931 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 277 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4059 |