| National Provider Identifier [NPI]: | 1295926483 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 MARIE CURIE BLVD. |
| Street Address 2 Of The Provider | BAYLOR MEDICAL CENTER AT GARLAND |
| City Of The Provider | GARLAND |
| Zip Code Of The Provider | 75042 |
| 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 | 175 |
| Number Of Services | 4722 |
| Number Of Medicare Beneficiaries | 2648 |
| Total Submitted Charge Amount | 628160.6 |
| Total Medicare Allowed Amount | 168711.09 |
| Total Medicare Payment Amount | 127210.18 |
| Total Medicare Standardized Payment Amount | 129065.22 |
| 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 | 4722 |
| Number Of Medicare Beneficiaries With Medical Services | 2648 |
| Total Medical Submitted Charge Amount | 628160.6 |
| Total Medical Medicare Allowed Amount | 168711.09 |
| Total Medical Medicare Payment Amount | 127210.18 |
| Total Medical Medicare Standardized Payment Amount | 129065.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 453 |
| Number Of Beneficiaries Age 65 to 74 | 943 |
| Number Of Beneficiaries Age 75 to 84 | 787 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 1609 |
| Number Of Male Beneficiaries | 1039 |
| Number Of Non Hispanic White Beneficiaries | 1794 |
| Number Of Black or African American Beneficiaries | 320 |
| Number Of AsianPacific Islander Beneficiaries | 270 |
| Number Of Hispanic Beneficiaries | 239 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 869 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9996 |