| National Provider Identifier [NPI]: | 1477733574 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | CAMERON |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 POLE LINE RD W |
| Street Address 2 Of The Provider | |
| City Of The Provider | TWIN FALLS |
| Zip Code Of The Provider | 833015810 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 219 |
| Number Of Services | 5754 |
| Number Of Medicare Beneficiaries | 3183 |
| Total Submitted Charge Amount | 547435 |
| Total Medicare Allowed Amount | 178691 |
| Total Medicare Payment Amount | 137485.45 |
| Total Medicare Standardized Payment Amount | 147009.39 |
| 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 | 219 |
| Number Of Medical Services | 5754 |
| Number Of Medicare Beneficiaries With Medical Services | 3183 |
| Total Medical Submitted Charge Amount | 547435 |
| Total Medical Medicare Allowed Amount | 178691 |
| Total Medical Medicare Payment Amount | 137485.45 |
| Total Medical Medicare Standardized Payment Amount | 147009.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 529 |
| Number Of Beneficiaries Age 65 to 74 | 1235 |
| Number Of Beneficiaries Age 75 to 84 | 960 |
| Number Of Beneficiaries Age Greater 84 | 459 |
| Number Of Female Beneficiaries | 1996 |
| Number Of Male Beneficiaries | 1187 |
| Number Of Non Hispanic White Beneficiaries | 2978 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2430 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 753 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4005 |