| National Provider Identifier [NPI]: | 1922054063 |
| Last Name Of The Provider | MACK |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11800 FM 1960 RD W |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770653840 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 3569 |
| Number Of Medicare Beneficiaries | 374 |
| Total Submitted Charge Amount | 2467560.2 |
| Total Medicare Allowed Amount | 234743.69 |
| Total Medicare Payment Amount | 176236.95 |
| Total Medicare Standardized Payment Amount | 177965.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2182 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 296135.5 |
| Total Drug Medicare AllowedAmount | 26514.82 |
| Total Drug Medicare PaymentAmount | 20676.04 |
| Total Drug Medicare Standardized Payment Amount | 20676.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1387 |
| Number Of Medicare Beneficiaries With Medical Services | 374 |
| Total Medical Submitted Charge Amount | 2171424.7 |
| Total Medical Medicare Allowed Amount | 208228.87 |
| Total Medical Medicare Payment Amount | 155560.91 |
| Total Medical Medicare Standardized Payment Amount | 157289.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 310 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 349 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2593 |