| National Provider Identifier [NPI]: | 1851491229 |
| Last Name Of The Provider | TODD |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 W FRANK |
| Street Address 2 Of The Provider | MEMORIAL MEDICAL CENTER |
| City Of The Provider | LUFKIN |
| Zip Code Of The Provider | 75904 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 2535 |
| Number Of Medicare Beneficiaries | 1266 |
| Total Submitted Charge Amount | 527268.61 |
| Total Medicare Allowed Amount | 85014.84 |
| Total Medicare Payment Amount | 66145.17 |
| Total Medicare Standardized Payment Amount | 56445.89 |
| 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 | 23 |
| Number Of Medical Services | 2535 |
| Number Of Medicare Beneficiaries With Medical Services | 1266 |
| Total Medical Submitted Charge Amount | 527268.61 |
| Total Medical Medicare Allowed Amount | 85014.84 |
| Total Medical Medicare Payment Amount | 66145.17 |
| Total Medical Medicare Standardized Payment Amount | 56445.89 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 218 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 388 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 678 |
| Number Of Male Beneficiaries | 588 |
| Number Of Non Hispanic White Beneficiaries | 1062 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 920 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 346 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6323 |