| National Provider Identifier [NPI]: | 1336298256 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1010 W BAKER RD |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | BAYTOWN |
| Zip Code Of The Provider | 775212382 |
| 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 | 102 |
| Number Of Services | 18733 |
| Number Of Medicare Beneficiaries | 965 |
| Total Submitted Charge Amount | 2084936 |
| Total Medicare Allowed Amount | 392544.54 |
| Total Medicare Payment Amount | 298805.29 |
| Total Medicare Standardized Payment Amount | 313165.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 16392 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 21607 |
| Total Drug Medicare AllowedAmount | 2773.01 |
| Total Drug Medicare PaymentAmount | 2174.45 |
| Total Drug Medicare Standardized Payment Amount | 2174.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 2341 |
| Number Of Medicare Beneficiaries With Medical Services | 965 |
| Total Medical Submitted Charge Amount | 2063329 |
| Total Medical Medicare Allowed Amount | 389771.53 |
| Total Medical Medicare Payment Amount | 296630.84 |
| Total Medical Medicare Standardized Payment Amount | 310991.44 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 410 |
| Number Of Beneficiaries Age 75 to 84 | 292 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 600 |
| Number Of Male Beneficiaries | 365 |
| Number Of Non Hispanic White Beneficiaries | 751 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 822 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 1.3321 |