| National Provider Identifier [NPI]: | 1639121254 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 816 W CANNON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761043146 |
| 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 | 155 |
| Number Of Services | 4837 |
| Number Of Medicare Beneficiaries | 3396 |
| Total Submitted Charge Amount | 601401 |
| Total Medicare Allowed Amount | 156156.21 |
| Total Medicare Payment Amount | 116660.43 |
| Total Medicare Standardized Payment Amount | 120035.46 |
| 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 | 155 |
| Number Of Medical Services | 4837 |
| Number Of Medicare Beneficiaries With Medical Services | 3396 |
| Total Medical Submitted Charge Amount | 601401 |
| Total Medical Medicare Allowed Amount | 156156.21 |
| Total Medical Medicare Payment Amount | 116660.43 |
| Total Medical Medicare Standardized Payment Amount | 120035.46 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 805 |
| Number Of Beneficiaries Age 65 to 74 | 1097 |
| Number Of Beneficiaries Age 75 to 84 | 917 |
| Number Of Beneficiaries Age Greater 84 | 577 |
| Number Of Female Beneficiaries | 2009 |
| Number Of Male Beneficiaries | 1387 |
| Number Of Non Hispanic White Beneficiaries | 2487 |
| Number Of Black or African American Beneficiaries | 503 |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 314 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1016 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3925 |