| National Provider Identifier [NPI]: | 1841220746 |
| Last Name Of The Provider | HAYCOCKS |
| First Name Of The Provider | IAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 PALOMINO LN |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064894 |
| 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 | 181 |
| Number Of Services | 9196 |
| Number Of Medicare Beneficiaries | 2881 |
| Total Submitted Charge Amount | 1081623.93 |
| Total Medicare Allowed Amount | 305104.3 |
| Total Medicare Payment Amount | 251682.02 |
| Total Medicare Standardized Payment Amount | 243941.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4674 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 9936.52 |
| Total Drug Medicare AllowedAmount | 1823.73 |
| Total Drug Medicare PaymentAmount | 1429.8 |
| Total Drug Medicare Standardized Payment Amount | 1429.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 4522 |
| Number Of Medicare Beneficiaries With Medical Services | 2880 |
| Total Medical Submitted Charge Amount | 1071687.41 |
| Total Medical Medicare Allowed Amount | 303280.57 |
| Total Medical Medicare Payment Amount | 250252.22 |
| Total Medical Medicare Standardized Payment Amount | 242511.49 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 542 |
| Number Of Beneficiaries Age 65 to 74 | 1271 |
| Number Of Beneficiaries Age 75 to 84 | 754 |
| Number Of Beneficiaries Age Greater 84 | 314 |
| Number Of Female Beneficiaries | 1975 |
| Number Of Male Beneficiaries | 906 |
| Number Of Non Hispanic White Beneficiaries | 1949 |
| Number Of Black or African American Beneficiaries | 437 |
| Number Of AsianPacific Islander Beneficiaries | 190 |
| Number Of Hispanic Beneficiaries | 240 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2150 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 731 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7278 |