| National Provider Identifier [NPI]: | 1306883483 |
| Last Name Of The Provider | KILGORE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8440 WALNUT HILL LN |
| Street Address 2 Of The Provider | SUITE 510 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752313833 |
| 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 | 67 |
| Number Of Services | 3706 |
| Number Of Medicare Beneficiaries | 1845 |
| Total Submitted Charge Amount | 1122786.64 |
| Total Medicare Allowed Amount | 218323.42 |
| Total Medicare Payment Amount | 166377.03 |
| Total Medicare Standardized Payment Amount | 171013.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 740 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 4996 |
| Total Drug Medicare AllowedAmount | 1182.97 |
| Total Drug Medicare PaymentAmount | 886.17 |
| Total Drug Medicare Standardized Payment Amount | 886.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 2966 |
| Number Of Medicare Beneficiaries With Medical Services | 1845 |
| Total Medical Submitted Charge Amount | 1117790.64 |
| Total Medical Medicare Allowed Amount | 217140.45 |
| Total Medical Medicare Payment Amount | 165490.86 |
| Total Medical Medicare Standardized Payment Amount | 170127.37 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 644 |
| Number Of Beneficiaries Age 75 to 84 | 605 |
| Number Of Beneficiaries Age Greater 84 | 384 |
| Number Of Female Beneficiaries | 1083 |
| Number Of Male Beneficiaries | 762 |
| Number Of Non Hispanic White Beneficiaries | 1585 |
| Number Of Black or African American Beneficiaries | 142 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1644 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.5256 |