| National Provider Identifier [NPI]: | 1871629964 |
| Last Name Of The Provider | SCHOSHINSKI |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6500 EXCELSIOR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554264702 |
| 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 | 117 |
| Number Of Services | 7020 |
| Number Of Medicare Beneficiaries | 1325 |
| Total Submitted Charge Amount | 271905.7 |
| Total Medicare Allowed Amount | 111160.46 |
| Total Medicare Payment Amount | 81389.18 |
| Total Medicare Standardized Payment Amount | 85029.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5197 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 2207.5 |
| Total Drug Medicare AllowedAmount | 1262.91 |
| Total Drug Medicare PaymentAmount | 986.56 |
| Total Drug Medicare Standardized Payment Amount | 986.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 1823 |
| Number Of Medicare Beneficiaries With Medical Services | 1325 |
| Total Medical Submitted Charge Amount | 269698.2 |
| Total Medical Medicare Allowed Amount | 109897.55 |
| Total Medical Medicare Payment Amount | 80402.62 |
| Total Medical Medicare Standardized Payment Amount | 84043.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 279 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 391 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 796 |
| Number Of Male Beneficiaries | 529 |
| Number Of Non Hispanic White Beneficiaries | 1180 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1016 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 309 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5814 |