| National Provider Identifier [NPI]: | 1477557239 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4807 SPICEWOOD SPRINGS RD |
| Street Address 2 Of The Provider | STE 1235 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787598478 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1625 |
| Number Of Medicare Beneficiaries | 153 |
| Total Submitted Charge Amount | 301670 |
| Total Medicare Allowed Amount | 115411.65 |
| Total Medicare Payment Amount | 81931.23 |
| Total Medicare Standardized Payment Amount | 86067.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 465 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 17616 |
| Total Drug Medicare AllowedAmount | 1205.65 |
| Total Drug Medicare PaymentAmount | 913.21 |
| Total Drug Medicare Standardized Payment Amount | 913.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1160 |
| Number Of Medicare Beneficiaries With Medical Services | 153 |
| Total Medical Submitted Charge Amount | 284054 |
| Total Medical Medicare Allowed Amount | 114206 |
| Total Medical Medicare Payment Amount | 81018.02 |
| Total Medical Medicare Standardized Payment Amount | 85154.13 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 127 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1718 |