| National Provider Identifier [NPI]: | 1841396025 |
| Last Name Of The Provider | ESCALANTE |
| First Name Of The Provider | BETHUNE |
| 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 | 3791 SYRACUSE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770051133 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 3125 |
| Number Of Medicare Beneficiaries | 1963 |
| Total Submitted Charge Amount | 577542 |
| Total Medicare Allowed Amount | 105370.24 |
| Total Medicare Payment Amount | 79773.5 |
| Total Medicare Standardized Payment Amount | 79827.08 |
| 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 | 189 |
| Number Of Medical Services | 3125 |
| Number Of Medicare Beneficiaries With Medical Services | 1963 |
| Total Medical Submitted Charge Amount | 577542 |
| Total Medical Medicare Allowed Amount | 105370.24 |
| Total Medical Medicare Payment Amount | 79773.5 |
| Total Medical Medicare Standardized Payment Amount | 79827.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 307 |
| Number Of Beneficiaries Age 65 to 74 | 707 |
| Number Of Beneficiaries Age 75 to 84 | 602 |
| Number Of Beneficiaries Age Greater 84 | 347 |
| Number Of Female Beneficiaries | 1164 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 1467 |
| Number Of Black or African American Beneficiaries | 236 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 181 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1617 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 346 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1072 |