| National Provider Identifier [NPI]: | 1336330869 |
| Last Name Of The Provider | WISE |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3501 N SCOTTSDALE RD |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852515648 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 42012 |
| Number Of Medicare Beneficiaries | 3049 |
| Total Submitted Charge Amount | 2324454.4 |
| Total Medicare Allowed Amount | 550268.47 |
| Total Medicare Payment Amount | 411954.59 |
| Total Medicare Standardized Payment Amount | 428118.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 36791 |
| Number Of Medicare Beneficiaries With Drug Services | 436 |
| Total Drug Submitted ChargeAmount | 76626.4 |
| Total Drug Medicare AllowedAmount | 12180.5 |
| Total Drug Medicare PaymentAmount | 9519.78 |
| Total Drug Medicare Standardized Payment Amount | 9519.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 5221 |
| Number Of Medicare Beneficiaries With Medical Services | 3047 |
| Total Medical Submitted Charge Amount | 2247828 |
| Total Medical Medicare Allowed Amount | 538087.97 |
| Total Medical Medicare Payment Amount | 402434.81 |
| Total Medical Medicare Standardized Payment Amount | 418598.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 1361 |
| Number Of Beneficiaries Age 75 to 84 | 985 |
| Number Of Beneficiaries Age Greater 84 | 491 |
| Number Of Female Beneficiaries | 1694 |
| Number Of Male Beneficiaries | 1355 |
| Number Of Non Hispanic White Beneficiaries | 2823 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | 41 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2871 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.3749 |