| National Provider Identifier [NPI]: | 1962408989 |
| Last Name Of The Provider | FAN |
| First Name Of The Provider | KARL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1521 S STAPLES ST |
| Street Address 2 Of The Provider | STE 301&304 |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784043150 |
| 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 | 251 |
| Number Of Services | 36170 |
| Number Of Medicare Beneficiaries | 3033 |
| Total Submitted Charge Amount | 1700088.35 |
| Total Medicare Allowed Amount | 549538.77 |
| Total Medicare Payment Amount | 417341.79 |
| Total Medicare Standardized Payment Amount | 445892.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 31388 |
| Number Of Medicare Beneficiaries With Drug Services | 416 |
| Total Drug Submitted ChargeAmount | 24379.5 |
| Total Drug Medicare AllowedAmount | 10509.87 |
| Total Drug Medicare PaymentAmount | 8090.63 |
| Total Drug Medicare Standardized Payment Amount | 8090.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 245 |
| Number Of Medical Services | 4782 |
| Number Of Medicare Beneficiaries With Medical Services | 3032 |
| Total Medical Submitted Charge Amount | 1675708.85 |
| Total Medical Medicare Allowed Amount | 539028.9 |
| Total Medical Medicare Payment Amount | 409251.16 |
| Total Medical Medicare Standardized Payment Amount | 437802.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 513 |
| Number Of Beneficiaries Age 65 to 74 | 1176 |
| Number Of Beneficiaries Age 75 to 84 | 881 |
| Number Of Beneficiaries Age Greater 84 | 463 |
| Number Of Female Beneficiaries | 1809 |
| Number Of Male Beneficiaries | 1224 |
| Number Of Non Hispanic White Beneficiaries | 1927 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 959 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2284 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 749 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7624 |