| National Provider Identifier [NPI]: | 1063456572 |
| Last Name Of The Provider | DO |
| First Name Of The Provider | NAM |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 S COULTER ST |
| Street Address 2 Of The Provider | SUITE #301 |
| City Of The Provider | AMARILLO |
| Zip Code Of The Provider | 791061758 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 18908 |
| Number Of Medicare Beneficiaries | 594 |
| Total Submitted Charge Amount | 783610.97 |
| Total Medicare Allowed Amount | 520327.91 |
| Total Medicare Payment Amount | 405019.82 |
| Total Medicare Standardized Payment Amount | 434311.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1323 |
| Number Of Medicare Beneficiaries With Drug Services | 376 |
| Total Drug Submitted ChargeAmount | 59707.72 |
| Total Drug Medicare AllowedAmount | 21414.34 |
| Total Drug Medicare PaymentAmount | 18723.98 |
| Total Drug Medicare Standardized Payment Amount | 18723.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 17585 |
| Number Of Medicare Beneficiaries With Medical Services | 594 |
| Total Medical Submitted Charge Amount | 723903.25 |
| Total Medical Medicare Allowed Amount | 498913.57 |
| Total Medical Medicare Payment Amount | 386295.84 |
| Total Medical Medicare Standardized Payment Amount | 415587.66 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 265 |
| Number Of Non Hispanic White Beneficiaries | 486 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 60 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0923 |