| National Provider Identifier [NPI]: | 1982634424 |
| Last Name Of The Provider | ALTSTATT |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 MILLER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROWNWOOD |
| Zip Code Of The Provider | 768015947 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 7006 |
| Number Of Medicare Beneficiaries | 1056 |
| Total Submitted Charge Amount | 1367368.01 |
| Total Medicare Allowed Amount | 481145.79 |
| Total Medicare Payment Amount | 360862.84 |
| Total Medicare Standardized Payment Amount | 376597.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 586 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 108780.01 |
| Total Drug Medicare AllowedAmount | 42577.79 |
| Total Drug Medicare PaymentAmount | 33104.44 |
| Total Drug Medicare Standardized Payment Amount | 33104.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 6420 |
| Number Of Medicare Beneficiaries With Medical Services | 1056 |
| Total Medical Submitted Charge Amount | 1258588 |
| Total Medical Medicare Allowed Amount | 438568 |
| Total Medical Medicare Payment Amount | 327758.4 |
| Total Medical Medicare Standardized Payment Amount | 343492.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 443 |
| Number Of Beneficiaries Age 75 to 84 | 389 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 281 |
| Number Of Male Beneficiaries | 775 |
| Number Of Non Hispanic White Beneficiaries | 962 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 871 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1385 |