| National Provider Identifier [NPI]: | 1457673956 |
| Last Name Of The Provider | PAN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| 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 | 235 |
| Number Of Services | 6754 |
| Number Of Medicare Beneficiaries | 3448 |
| Total Submitted Charge Amount | 827317.3 |
| Total Medicare Allowed Amount | 164844.39 |
| Total Medicare Payment Amount | 126115.42 |
| Total Medicare Standardized Payment Amount | 129688.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1680 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 834.8 |
| Total Drug Medicare AllowedAmount | 303.44 |
| Total Drug Medicare PaymentAmount | 214.91 |
| Total Drug Medicare Standardized Payment Amount | 214.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 234 |
| Number Of Medical Services | 5074 |
| Number Of Medicare Beneficiaries With Medical Services | 3448 |
| Total Medical Submitted Charge Amount | 826482.5 |
| Total Medical Medicare Allowed Amount | 164540.95 |
| Total Medical Medicare Payment Amount | 125900.51 |
| Total Medical Medicare Standardized Payment Amount | 129473.62 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 715 |
| Number Of Beneficiaries Age 65 to 74 | 1273 |
| Number Of Beneficiaries Age 75 to 84 | 930 |
| Number Of Beneficiaries Age Greater 84 | 530 |
| Number Of Female Beneficiaries | 1965 |
| Number Of Male Beneficiaries | 1483 |
| Number Of Non Hispanic White Beneficiaries | 2449 |
| Number Of Black or African American Beneficiaries | 367 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 545 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 991 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0649 |