| National Provider Identifier [NPI]: | 1780674374 |
| Last Name Of The Provider | BECKER |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MEDICAL DOCTOR |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 65 N MADISON AVE |
| Street Address 2 Of The Provider | LOWER LEVEL |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911012035 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 2720 |
| Number Of Medicare Beneficiaries | 899 |
| Total Submitted Charge Amount | 502656 |
| Total Medicare Allowed Amount | 138731.21 |
| Total Medicare Payment Amount | 109602.76 |
| Total Medicare Standardized Payment Amount | 97850.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1274 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 5110 |
| Total Drug Medicare AllowedAmount | 698.24 |
| Total Drug Medicare PaymentAmount | 547.4 |
| Total Drug Medicare Standardized Payment Amount | 547.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 1446 |
| Number Of Medicare Beneficiaries With Medical Services | 899 |
| Total Medical Submitted Charge Amount | 497546 |
| Total Medical Medicare Allowed Amount | 138032.97 |
| Total Medical Medicare Payment Amount | 109055.36 |
| Total Medical Medicare Standardized Payment Amount | 97302.86 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 179 |
| Number Of Beneficiaries Age 65 to 74 | 416 |
| Number Of Beneficiaries Age 75 to 84 | 211 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 609 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 498 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | 62 |
| Number Of Hispanic Beneficiaries | 171 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 522 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 377 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1832 |