| National Provider Identifier [NPI]: | 1417940420 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | KRISTIE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 224 E 2ND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUMAS |
| Zip Code Of The Provider | 790293808 |
| 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 | 117 |
| Number Of Services | 3968 |
| Number Of Medicare Beneficiaries | 2952 |
| Total Submitted Charge Amount | 586631.03 |
| Total Medicare Allowed Amount | 120928.38 |
| Total Medicare Payment Amount | 92175.9 |
| Total Medicare Standardized Payment Amount | 93356.5 |
| 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 | 117 |
| Number Of Medical Services | 3968 |
| Number Of Medicare Beneficiaries With Medical Services | 2952 |
| Total Medical Submitted Charge Amount | 586631.03 |
| Total Medical Medicare Allowed Amount | 120928.38 |
| Total Medical Medicare Payment Amount | 92175.9 |
| Total Medical Medicare Standardized Payment Amount | 93356.5 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 842 |
| Number Of Beneficiaries Age 65 to 74 | 826 |
| Number Of Beneficiaries Age 75 to 84 | 782 |
| Number Of Beneficiaries Age Greater 84 | 502 |
| Number Of Female Beneficiaries | 1690 |
| Number Of Male Beneficiaries | 1262 |
| Number Of Non Hispanic White Beneficiaries | 2292 |
| Number Of Black or African American Beneficiaries | 516 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1659 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1293 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1311 |