| National Provider Identifier [NPI]: | 1588835326 |
| Last Name Of The Provider | LONGO |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6565 FANNIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770302703 |
| 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 | 166 |
| Number Of Services | 5591 |
| Number Of Medicare Beneficiaries | 3952 |
| Total Submitted Charge Amount | 884830 |
| Total Medicare Allowed Amount | 160947.86 |
| Total Medicare Payment Amount | 122685.59 |
| Total Medicare Standardized Payment Amount | 123992.24 |
| 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 | 166 |
| Number Of Medical Services | 5591 |
| Number Of Medicare Beneficiaries With Medical Services | 3952 |
| Total Medical Submitted Charge Amount | 884830 |
| Total Medical Medicare Allowed Amount | 160947.86 |
| Total Medical Medicare Payment Amount | 122685.59 |
| Total Medical Medicare Standardized Payment Amount | 123992.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 695 |
| Number Of Beneficiaries Age 65 to 74 | 1499 |
| Number Of Beneficiaries Age 75 to 84 | 1088 |
| Number Of Beneficiaries Age Greater 84 | 670 |
| Number Of Female Beneficiaries | 2221 |
| Number Of Male Beneficiaries | 1731 |
| Number Of Non Hispanic White Beneficiaries | 2539 |
| Number Of Black or African American Beneficiaries | 788 |
| Number Of AsianPacific Islander Beneficiaries | 170 |
| Number Of Hispanic Beneficiaries | 401 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3098 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 854 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.6021 |