| National Provider Identifier [NPI]: | 1467646026 |
| Last Name Of The Provider | MA |
| First Name Of The Provider | CALVIN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3061 S MARYLAND PKWY STE 102 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891096226 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 10170 |
| Number Of Medicare Beneficiaries | 2823 |
| Total Submitted Charge Amount | 932891 |
| Total Medicare Allowed Amount | 226436.3 |
| Total Medicare Payment Amount | 177884.41 |
| Total Medicare Standardized Payment Amount | 170917.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 6334 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 8278 |
| Total Drug Medicare AllowedAmount | 1623.24 |
| Total Drug Medicare PaymentAmount | 1272.71 |
| Total Drug Medicare Standardized Payment Amount | 1272.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 3836 |
| Number Of Medicare Beneficiaries With Medical Services | 2823 |
| Total Medical Submitted Charge Amount | 924613 |
| Total Medical Medicare Allowed Amount | 224813.06 |
| Total Medical Medicare Payment Amount | 176611.7 |
| Total Medical Medicare Standardized Payment Amount | 169645.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 503 |
| Number Of Beneficiaries Age 65 to 74 | 1075 |
| Number Of Beneficiaries Age 75 to 84 | 803 |
| Number Of Beneficiaries Age Greater 84 | 442 |
| Number Of Female Beneficiaries | 1689 |
| Number Of Male Beneficiaries | 1134 |
| Number Of Non Hispanic White Beneficiaries | 2031 |
| Number Of Black or African American Beneficiaries | 268 |
| Number Of AsianPacific Islander Beneficiaries | 171 |
| Number Of Hispanic Beneficiaries | 279 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2067 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 756 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9764 |