| National Provider Identifier [NPI]: | 1639272164 |
| Last Name Of The Provider | OPTICAN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6019 WALNUT GROVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38120 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 175 |
| Number Of Services | 6758 |
| Number Of Medicare Beneficiaries | 4812 |
| Total Submitted Charge Amount | 976084 |
| Total Medicare Allowed Amount | 248330.55 |
| Total Medicare Payment Amount | 186859.27 |
| Total Medicare Standardized Payment Amount | 200322.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 175 |
| Number Of Medical Services | 6758 |
| Number Of Medicare Beneficiaries With Medical Services | 4812 |
| Total Medical Submitted Charge Amount | 976084 |
| Total Medical Medicare Allowed Amount | 248330.55 |
| Total Medical Medicare Payment Amount | 186859.27 |
| Total Medical Medicare Standardized Payment Amount | 200322.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 845 |
| Number Of Beneficiaries Age 65 to 74 | 1781 |
| Number Of Beneficiaries Age 75 to 84 | 1493 |
| Number Of Beneficiaries Age Greater 84 | 693 |
| Number Of Female Beneficiaries | 2681 |
| Number Of Male Beneficiaries | 2131 |
| Number Of Non Hispanic White Beneficiaries | 3596 |
| Number Of Black or African American Beneficiaries | 1119 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3641 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1171 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0643 |