| National Provider Identifier [NPI]: | 1619920402 |
| Last Name Of The Provider | PHILIP |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 GASTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752462017 |
| 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 | 122 |
| Number Of Services | 4078 |
| Number Of Medicare Beneficiaries | 2423 |
| Total Submitted Charge Amount | 803551.04 |
| Total Medicare Allowed Amount | 186583.29 |
| Total Medicare Payment Amount | 142713.74 |
| Total Medicare Standardized Payment Amount | 145436.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 276 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1990.72 |
| Total Drug Medicare AllowedAmount | 278.59 |
| Total Drug Medicare PaymentAmount | 218.42 |
| Total Drug Medicare Standardized Payment Amount | 218.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 3802 |
| Number Of Medicare Beneficiaries With Medical Services | 2423 |
| Total Medical Submitted Charge Amount | 801560.32 |
| Total Medical Medicare Allowed Amount | 186304.7 |
| Total Medical Medicare Payment Amount | 142495.32 |
| Total Medical Medicare Standardized Payment Amount | 145218.37 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 547 |
| Number Of Beneficiaries Age 65 to 74 | 956 |
| Number Of Beneficiaries Age 75 to 84 | 615 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 1417 |
| Number Of Male Beneficiaries | 1006 |
| Number Of Non Hispanic White Beneficiaries | 1526 |
| Number Of Black or African American Beneficiaries | 664 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 188 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 721 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.206 |