| National Provider Identifier [NPI]: | 1861478794 |
| Last Name Of The Provider | ALDRIDGE |
| First Name Of The Provider | MILISSA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7026 OLD KATY RD |
| Street Address 2 Of The Provider | SUITE 276 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770242133 |
| 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 | 135 |
| Number Of Services | 4396 |
| Number Of Medicare Beneficiaries | 3167 |
| Total Submitted Charge Amount | 628557 |
| Total Medicare Allowed Amount | 129415 |
| Total Medicare Payment Amount | 99852.82 |
| Total Medicare Standardized Payment Amount | 104125.81 |
| 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 | 135 |
| Number Of Medical Services | 4396 |
| Number Of Medicare Beneficiaries With Medical Services | 3167 |
| Total Medical Submitted Charge Amount | 628557 |
| Total Medical Medicare Allowed Amount | 129415 |
| Total Medical Medicare Payment Amount | 99852.82 |
| Total Medical Medicare Standardized Payment Amount | 104125.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 466 |
| Number Of Beneficiaries Age 65 to 74 | 1319 |
| Number Of Beneficiaries Age 75 to 84 | 904 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 1925 |
| Number Of Male Beneficiaries | 1242 |
| Number Of Non Hispanic White Beneficiaries | 2437 |
| Number Of Black or African American Beneficiaries | 403 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 261 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 595 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9653 |