| National Provider Identifier [NPI]: | 1245227370 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 W COLUMBIA ST |
| Street Address 2 Of The Provider | SUITE 420 |
| City Of The Provider | EVANSVILLE |
| Zip Code Of The Provider | 477101782 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 252 |
| Number Of Services | 9301 |
| Number Of Medicare Beneficiaries | 5330 |
| Total Submitted Charge Amount | 2140664.85 |
| Total Medicare Allowed Amount | 385666.82 |
| Total Medicare Payment Amount | 297118.63 |
| Total Medicare Standardized Payment Amount | 313571.91 |
| 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 | 252 |
| Number Of Medical Services | 9301 |
| Number Of Medicare Beneficiaries With Medical Services | 5330 |
| Total Medical Submitted Charge Amount | 2140664.85 |
| Total Medical Medicare Allowed Amount | 385666.82 |
| Total Medical Medicare Payment Amount | 297118.63 |
| Total Medical Medicare Standardized Payment Amount | 313571.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1076 |
| Number Of Beneficiaries Age 65 to 74 | 1897 |
| Number Of Beneficiaries Age 75 to 84 | 1494 |
| Number Of Beneficiaries Age Greater 84 | 863 |
| Number Of Female Beneficiaries | 3030 |
| Number Of Male Beneficiaries | 2300 |
| Number Of Non Hispanic White Beneficiaries | 4997 |
| Number Of Black or African American Beneficiaries | 261 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3944 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1386 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6099 |