| National Provider Identifier [NPI]: | 1700885811 |
| Last Name Of The Provider | HATTEN |
| First Name Of The Provider | HOMER |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1485 37TH ST |
| Street Address 2 Of The Provider | SUITE 107 |
| City Of The Provider | VERO BEACH |
| Zip Code Of The Provider | 329606500 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3079 |
| Number Of Medicare Beneficiaries | 994 |
| Total Submitted Charge Amount | 994181.73 |
| Total Medicare Allowed Amount | 237466.53 |
| Total Medicare Payment Amount | 183712.29 |
| Total Medicare Standardized Payment Amount | 178665.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1788 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 15123.1 |
| Total Drug Medicare AllowedAmount | 3190.17 |
| Total Drug Medicare PaymentAmount | 2468.84 |
| Total Drug Medicare Standardized Payment Amount | 2468.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 1291 |
| Number Of Medicare Beneficiaries With Medical Services | 990 |
| Total Medical Submitted Charge Amount | 979058.63 |
| Total Medical Medicare Allowed Amount | 234276.36 |
| Total Medical Medicare Payment Amount | 181243.45 |
| Total Medical Medicare Standardized Payment Amount | 176196.89 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 422 |
| Number Of Beneficiaries Age 75 to 84 | 303 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 568 |
| Number Of Male Beneficiaries | 426 |
| Number Of Non Hispanic White Beneficiaries | 826 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 844 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0884 |