| National Provider Identifier [NPI]: | 1417966052 |
| Last Name Of The Provider | HURDISS |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 RICHMOND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770983106 |
| 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 | 165 |
| Number Of Services | 4462 |
| Number Of Medicare Beneficiaries | 3021 |
| Total Submitted Charge Amount | 4917078.95 |
| Total Medicare Allowed Amount | 561068.4 |
| Total Medicare Payment Amount | 417117.61 |
| Total Medicare Standardized Payment Amount | 439636.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 10640 |
| Total Drug Medicare AllowedAmount | 10.93 |
| Total Drug Medicare PaymentAmount | 8.64 |
| Total Drug Medicare Standardized Payment Amount | 8.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 4408 |
| Number Of Medicare Beneficiaries With Medical Services | 3021 |
| Total Medical Submitted Charge Amount | 4906438.95 |
| Total Medical Medicare Allowed Amount | 561057.47 |
| Total Medical Medicare Payment Amount | 417108.97 |
| Total Medical Medicare Standardized Payment Amount | 439627.48 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 690 |
| Number Of Beneficiaries Age 65 to 74 | 1451 |
| Number Of Beneficiaries Age 75 to 84 | 663 |
| Number Of Beneficiaries Age Greater 84 | 217 |
| Number Of Female Beneficiaries | 1865 |
| Number Of Male Beneficiaries | 1156 |
| Number Of Non Hispanic White Beneficiaries | 1839 |
| Number Of Black or African American Beneficiaries | 484 |
| Number Of AsianPacific Islander Beneficiaries | 85 |
| Number Of Hispanic Beneficiaries | 581 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2208 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 813 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2188 |