| National Provider Identifier [NPI]: | 1083662803 |
| Last Name Of The Provider | STEIN |
| First Name Of The Provider | MONI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3237 S 16TH ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPT. 2ND FLOOR |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532154526 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 228 |
| Number Of Services | 4089 |
| Number Of Medicare Beneficiaries | 2763 |
| Total Submitted Charge Amount | 762396 |
| Total Medicare Allowed Amount | 173583.63 |
| Total Medicare Payment Amount | 131298.11 |
| Total Medicare Standardized Payment Amount | 135136.22 |
| 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 | 228 |
| Number Of Medical Services | 4089 |
| Number Of Medicare Beneficiaries With Medical Services | 2763 |
| Total Medical Submitted Charge Amount | 762396 |
| Total Medical Medicare Allowed Amount | 173583.63 |
| Total Medical Medicare Payment Amount | 131298.11 |
| Total Medical Medicare Standardized Payment Amount | 135136.22 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 798 |
| Number Of Beneficiaries Age 65 to 74 | 897 |
| Number Of Beneficiaries Age 75 to 84 | 668 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1593 |
| Number Of Male Beneficiaries | 1170 |
| Number Of Non Hispanic White Beneficiaries | 2386 |
| Number Of Black or African American Beneficiaries | 322 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1148 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0207 |