| National Provider Identifier [NPI]: | 1033271846 |
| Last Name Of The Provider | LLAVE |
| First Name Of The Provider | ALFRED |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 837 S FLEISHEL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757012017 |
| 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 | 246 |
| Number Of Services | 9675 |
| Number Of Medicare Beneficiaries | 6535 |
| Total Submitted Charge Amount | 1241408.66 |
| Total Medicare Allowed Amount | 333090.2 |
| Total Medicare Payment Amount | 253540.34 |
| Total Medicare Standardized Payment Amount | 267181.13 |
| 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 | 246 |
| Number Of Medical Services | 9675 |
| Number Of Medicare Beneficiaries With Medical Services | 6535 |
| Total Medical Submitted Charge Amount | 1241408.66 |
| Total Medical Medicare Allowed Amount | 333090.2 |
| Total Medical Medicare Payment Amount | 253540.34 |
| Total Medical Medicare Standardized Payment Amount | 267181.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1153 |
| Number Of Beneficiaries Age 65 to 74 | 2368 |
| Number Of Beneficiaries Age 75 to 84 | 1952 |
| Number Of Beneficiaries Age Greater 84 | 1062 |
| Number Of Female Beneficiaries | 3613 |
| Number Of Male Beneficiaries | 2922 |
| Number Of Non Hispanic White Beneficiaries | 5488 |
| Number Of Black or African American Beneficiaries | 816 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 185 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4854 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1681 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8025 |