| National Provider Identifier [NPI]: | 1033163399 |
| Last Name Of The Provider | OPATOWSKY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| 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 | 55 |
| Number Of Services | 2671 |
| Number Of Medicare Beneficiaries | 1649 |
| Total Submitted Charge Amount | 670477.72 |
| Total Medicare Allowed Amount | 157323.63 |
| Total Medicare Payment Amount | 119520.08 |
| Total Medicare Standardized Payment Amount | 125151.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 352 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 2645.4 |
| Total Drug Medicare AllowedAmount | 393.53 |
| Total Drug Medicare PaymentAmount | 308.54 |
| Total Drug Medicare Standardized Payment Amount | 308.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2319 |
| Number Of Medicare Beneficiaries With Medical Services | 1649 |
| Total Medical Submitted Charge Amount | 667832.32 |
| Total Medical Medicare Allowed Amount | 156930.1 |
| Total Medical Medicare Payment Amount | 119211.54 |
| Total Medical Medicare Standardized Payment Amount | 124842.96 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 349 |
| Number Of Beneficiaries Age 65 to 74 | 635 |
| Number Of Beneficiaries Age 75 to 84 | 455 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 931 |
| Number Of Male Beneficiaries | 718 |
| Number Of Non Hispanic White Beneficiaries | 1144 |
| Number Of Black or African American Beneficiaries | 334 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 433 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 28 |
| Average HCC Risk Score Of Beneficiaries | 1.9591 |