| National Provider Identifier [NPI]: | 1053364927 |
| Last Name Of The Provider | DOCKERY |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5546 DRANE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752095506 |
| 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 | 144 |
| Number Of Services | 4169 |
| Number Of Medicare Beneficiaries | 2398 |
| Total Submitted Charge Amount | 715154.54 |
| Total Medicare Allowed Amount | 160265.01 |
| Total Medicare Payment Amount | 122861.96 |
| Total Medicare Standardized Payment Amount | 124925.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 718 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1968.44 |
| Total Drug Medicare AllowedAmount | 150.46 |
| Total Drug Medicare PaymentAmount | 117.97 |
| Total Drug Medicare Standardized Payment Amount | 117.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 3451 |
| Number Of Medicare Beneficiaries With Medical Services | 2398 |
| Total Medical Submitted Charge Amount | 713186.1 |
| Total Medical Medicare Allowed Amount | 160114.55 |
| Total Medical Medicare Payment Amount | 122743.99 |
| Total Medical Medicare Standardized Payment Amount | 124807.59 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 532 |
| Number Of Beneficiaries Age 65 to 74 | 905 |
| Number Of Beneficiaries Age 75 to 84 | 665 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 1321 |
| Number Of Male Beneficiaries | 1077 |
| Number Of Non Hispanic White Beneficiaries | 1618 |
| Number Of Black or African American Beneficiaries | 484 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 245 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1778 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 620 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2855 |