| National Provider Identifier [NPI]: | 1922052646 |
| Last Name Of The Provider | HOSTETTER |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 N I-35 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DENTON |
| Zip Code Of The Provider | 762015119 |
| 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 | 181 |
| Number Of Services | 5844 |
| Number Of Medicare Beneficiaries | 2689 |
| Total Submitted Charge Amount | 584779.38 |
| Total Medicare Allowed Amount | 150261.77 |
| Total Medicare Payment Amount | 117650.81 |
| Total Medicare Standardized Payment Amount | 123754.66 |
| 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 | 181 |
| Number Of Medical Services | 5844 |
| Number Of Medicare Beneficiaries With Medical Services | 2689 |
| Total Medical Submitted Charge Amount | 584779.38 |
| Total Medical Medicare Allowed Amount | 150261.77 |
| Total Medical Medicare Payment Amount | 117650.81 |
| Total Medical Medicare Standardized Payment Amount | 123754.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 489 |
| Number Of Beneficiaries Age 65 to 74 | 1058 |
| Number Of Beneficiaries Age 75 to 84 | 766 |
| Number Of Beneficiaries Age Greater 84 | 376 |
| Number Of Female Beneficiaries | 1781 |
| Number Of Male Beneficiaries | 908 |
| Number Of Non Hispanic White Beneficiaries | 2383 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 120 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2057 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 632 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5826 |