| National Provider Identifier [NPI]: | 1134136260 |
| Last Name Of The Provider | ALLEMAN |
| First Name Of The Provider | WADE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3269 STOCKTON HILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KINGMAN |
| Zip Code Of The Provider | 864093619 |
| 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 | 260 |
| Number Of Services | 7212 |
| Number Of Medicare Beneficiaries | 3247 |
| Total Submitted Charge Amount | 1463089 |
| Total Medicare Allowed Amount | 358888 |
| Total Medicare Payment Amount | 274407.3 |
| Total Medicare Standardized Payment Amount | 278136.95 |
| 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 | 260 |
| Number Of Medical Services | 7212 |
| Number Of Medicare Beneficiaries With Medical Services | 3247 |
| Total Medical Submitted Charge Amount | 1463089 |
| Total Medical Medicare Allowed Amount | 358888 |
| Total Medical Medicare Payment Amount | 274407.3 |
| Total Medical Medicare Standardized Payment Amount | 278136.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 480 |
| Number Of Beneficiaries Age 65 to 74 | 1491 |
| Number Of Beneficiaries Age 75 to 84 | 942 |
| Number Of Beneficiaries Age Greater 84 | 334 |
| Number Of Female Beneficiaries | 1925 |
| Number Of Male Beneficiaries | 1322 |
| Number Of Non Hispanic White Beneficiaries | 3000 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 132 |
| Number Of American Indian Alaska Native Beneficiaries | 50 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 627 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4331 |