| National Provider Identifier [NPI]: | 1861723108 |
| Last Name Of The Provider | THAVER |
| First Name Of The Provider | GHULAM |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| 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 | 198 |
| Number Of Services | 11567 |
| Number Of Medicare Beneficiaries | 2834 |
| Total Submitted Charge Amount | 2405199.2 |
| Total Medicare Allowed Amount | 891166.78 |
| Total Medicare Payment Amount | 684601.32 |
| Total Medicare Standardized Payment Amount | 688660.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 7161 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 54835.2 |
| Total Drug Medicare AllowedAmount | 22382.17 |
| Total Drug Medicare PaymentAmount | 15522.4 |
| Total Drug Medicare Standardized Payment Amount | 15522.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 190 |
| Number Of Medical Services | 4406 |
| Number Of Medicare Beneficiaries With Medical Services | 2834 |
| Total Medical Submitted Charge Amount | 2350364 |
| Total Medical Medicare Allowed Amount | 868784.61 |
| Total Medical Medicare Payment Amount | 669078.92 |
| Total Medical Medicare Standardized Payment Amount | 673138.41 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 517 |
| Number Of Beneficiaries Age 65 to 74 | 1182 |
| Number Of Beneficiaries Age 75 to 84 | 732 |
| Number Of Beneficiaries Age Greater 84 | 403 |
| Number Of Female Beneficiaries | 1663 |
| Number Of Male Beneficiaries | 1171 |
| Number Of Non Hispanic White Beneficiaries | 2076 |
| Number Of Black or African American Beneficiaries | 283 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 402 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2170 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 664 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7959 |