| National Provider Identifier [NPI]: | 1114971165 |
| Last Name Of The Provider | GLASTAD |
| First Name Of The Provider | KARL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 GASTON AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 75246 |
| 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 | 149 |
| Number Of Services | 7732 |
| Number Of Medicare Beneficiaries | 2338 |
| Total Submitted Charge Amount | 1298181.22 |
| Total Medicare Allowed Amount | 230136.1 |
| Total Medicare Payment Amount | 175440.56 |
| Total Medicare Standardized Payment Amount | 179619.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4431 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 26885 |
| Total Drug Medicare AllowedAmount | 2212.52 |
| Total Drug Medicare PaymentAmount | 1718.4 |
| Total Drug Medicare Standardized Payment Amount | 1718.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 3301 |
| Number Of Medicare Beneficiaries With Medical Services | 2338 |
| Total Medical Submitted Charge Amount | 1271296.22 |
| Total Medical Medicare Allowed Amount | 227923.58 |
| Total Medical Medicare Payment Amount | 173722.16 |
| Total Medical Medicare Standardized Payment Amount | 177901.31 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 457 |
| Number Of Beneficiaries Age 65 to 74 | 988 |
| Number Of Beneficiaries Age 75 to 84 | 657 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 1308 |
| Number Of Male Beneficiaries | 1030 |
| Number Of Non Hispanic White Beneficiaries | 1615 |
| Number Of Black or African American Beneficiaries | 416 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 253 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1787 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 551 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0103 |