| National Provider Identifier [NPI]: | 1548269137 |
| Last Name Of The Provider | HEATHCOCK |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 533 S 336TH ST |
| Street Address 2 Of The Provider | STE C |
| City Of The Provider | FEDERAL WAY |
| Zip Code Of The Provider | 980036329 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 5940 |
| Number Of Medicare Beneficiaries | 2125 |
| Total Submitted Charge Amount | 439601.4 |
| Total Medicare Allowed Amount | 124451.03 |
| Total Medicare Payment Amount | 95445.3 |
| Total Medicare Standardized Payment Amount | 90703.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2487 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3814.2 |
| Total Drug Medicare AllowedAmount | 913.41 |
| Total Drug Medicare PaymentAmount | 699.88 |
| Total Drug Medicare Standardized Payment Amount | 699.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 140 |
| Number Of Medical Services | 3453 |
| Number Of Medicare Beneficiaries With Medical Services | 2125 |
| Total Medical Submitted Charge Amount | 435787.2 |
| Total Medical Medicare Allowed Amount | 123537.62 |
| Total Medical Medicare Payment Amount | 94745.42 |
| Total Medical Medicare Standardized Payment Amount | 90004.04 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 363 |
| Number Of Beneficiaries Age 65 to 74 | 809 |
| Number Of Beneficiaries Age 75 to 84 | 627 |
| Number Of Beneficiaries Age Greater 84 | 326 |
| Number Of Female Beneficiaries | 1459 |
| Number Of Male Beneficiaries | 666 |
| Number Of Non Hispanic White Beneficiaries | 1700 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | 150 |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | 27 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1536 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 589 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6354 |