| National Provider Identifier [NPI]: | 1912990987 |
| Last Name Of The Provider | CO |
| First Name Of The Provider | MARK |
| 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 | 9330 POPPY DR |
| Street Address 2 Of The Provider | #503 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752184621 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 5085 |
| Number Of Medicare Beneficiaries | 461 |
| Total Submitted Charge Amount | 836460.83 |
| Total Medicare Allowed Amount | 397708.96 |
| Total Medicare Payment Amount | 308138 |
| Total Medicare Standardized Payment Amount | 307102.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 274 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 8530 |
| Total Drug Medicare AllowedAmount | 1974.24 |
| Total Drug Medicare PaymentAmount | 1632.56 |
| Total Drug Medicare Standardized Payment Amount | 1632.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 4811 |
| Number Of Medicare Beneficiaries With Medical Services | 461 |
| Total Medical Submitted Charge Amount | 827930.83 |
| Total Medical Medicare Allowed Amount | 395734.72 |
| Total Medical Medicare Payment Amount | 306505.44 |
| Total Medical Medicare Standardized Payment Amount | 305469.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 264 |
| Number Of Male Beneficiaries | 197 |
| Number Of Non Hispanic White Beneficiaries | 337 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 280 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 44 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 64 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.768 |