| National Provider Identifier [NPI]: | 1265403414 |
| Last Name Of The Provider | ROACH |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 677 N WILMOT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857112701 |
| 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 | 157 |
| Number Of Services | 44151 |
| Number Of Medicare Beneficiaries | 2882 |
| Total Submitted Charge Amount | 1395409 |
| Total Medicare Allowed Amount | 449743.53 |
| Total Medicare Payment Amount | 338070.85 |
| Total Medicare Standardized Payment Amount | 346600.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 40337 |
| Number Of Medicare Beneficiaries With Drug Services | 430 |
| Total Drug Submitted ChargeAmount | 42248 |
| Total Drug Medicare AllowedAmount | 8487.3 |
| Total Drug Medicare PaymentAmount | 6612.52 |
| Total Drug Medicare Standardized Payment Amount | 6612.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 154 |
| Number Of Medical Services | 3814 |
| Number Of Medicare Beneficiaries With Medical Services | 2882 |
| Total Medical Submitted Charge Amount | 1353161 |
| Total Medical Medicare Allowed Amount | 441256.23 |
| Total Medical Medicare Payment Amount | 331458.33 |
| Total Medical Medicare Standardized Payment Amount | 339988.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 287 |
| Number Of Beneficiaries Age 65 to 74 | 1248 |
| Number Of Beneficiaries Age 75 to 84 | 938 |
| Number Of Beneficiaries Age Greater 84 | 409 |
| Number Of Female Beneficiaries | 1635 |
| Number Of Male Beneficiaries | 1247 |
| Number Of Non Hispanic White Beneficiaries | 2464 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 251 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 365 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4174 |