| National Provider Identifier [NPI]: | 1245278597 |
| Last Name Of The Provider | STAEWEN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12951 SOUTH FREEWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770471923 |
| 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 | 128 |
| Number Of Services | 3639 |
| Number Of Medicare Beneficiaries | 1845 |
| Total Submitted Charge Amount | 1015143 |
| Total Medicare Allowed Amount | 187872.14 |
| Total Medicare Payment Amount | 144068.56 |
| Total Medicare Standardized Payment Amount | 145287.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 474 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 6696 |
| Total Drug Medicare AllowedAmount | 940.95 |
| Total Drug Medicare PaymentAmount | 737.72 |
| Total Drug Medicare Standardized Payment Amount | 737.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 3165 |
| Number Of Medicare Beneficiaries With Medical Services | 1845 |
| Total Medical Submitted Charge Amount | 1008447 |
| Total Medical Medicare Allowed Amount | 186931.19 |
| Total Medical Medicare Payment Amount | 143330.84 |
| Total Medical Medicare Standardized Payment Amount | 144550.23 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 287 |
| Number Of Beneficiaries Age 65 to 74 | 883 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 1132 |
| Number Of Male Beneficiaries | 713 |
| Number Of Non Hispanic White Beneficiaries | 1316 |
| Number Of Black or African American Beneficiaries | 317 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 256 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4217 |