| National Provider Identifier [NPI]: | 1700876646 |
| Last Name Of The Provider | HAGMAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5901 TECHNOLOGY CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462786013 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 11365 |
| Number Of Medicare Beneficiaries | 6527 |
| Total Submitted Charge Amount | 837656 |
| Total Medicare Allowed Amount | 274407.76 |
| Total Medicare Payment Amount | 225066.41 |
| Total Medicare Standardized Payment Amount | 237793.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1500 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 750 |
| Total Drug Medicare AllowedAmount | 289.1 |
| Total Drug Medicare PaymentAmount | 226.64 |
| Total Drug Medicare Standardized Payment Amount | 226.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 9865 |
| Number Of Medicare Beneficiaries With Medical Services | 6527 |
| Total Medical Submitted Charge Amount | 836906 |
| Total Medical Medicare Allowed Amount | 274118.66 |
| Total Medical Medicare Payment Amount | 224839.77 |
| Total Medical Medicare Standardized Payment Amount | 237567.02 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 979 |
| Number Of Beneficiaries Age 65 to 74 | 2924 |
| Number Of Beneficiaries Age 75 to 84 | 1886 |
| Number Of Beneficiaries Age Greater 84 | 738 |
| Number Of Female Beneficiaries | 4767 |
| Number Of Male Beneficiaries | 1760 |
| Number Of Non Hispanic White Beneficiaries | 5854 |
| Number Of Black or African American Beneficiaries | 505 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 76 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5276 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1251 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4269 |