| National Provider Identifier [NPI]: | 1023073822 |
| Last Name Of The Provider | AVERY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1717 HIGHWAY 59 LOOP N |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIVINGSTON |
| Zip Code Of The Provider | 773515703 |
| 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 | 186 |
| Number Of Services | 5821 |
| Number Of Medicare Beneficiaries | 2822 |
| Total Submitted Charge Amount | 661068 |
| Total Medicare Allowed Amount | 171094.73 |
| Total Medicare Payment Amount | 135379.95 |
| Total Medicare Standardized Payment Amount | 140937.62 |
| 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 | 186 |
| Number Of Medical Services | 5821 |
| Number Of Medicare Beneficiaries With Medical Services | 2822 |
| Total Medical Submitted Charge Amount | 661068 |
| Total Medical Medicare Allowed Amount | 171094.73 |
| Total Medical Medicare Payment Amount | 135379.95 |
| Total Medical Medicare Standardized Payment Amount | 140937.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 537 |
| Number Of Beneficiaries Age 65 to 74 | 1090 |
| Number Of Beneficiaries Age 75 to 84 | 845 |
| Number Of Beneficiaries Age Greater 84 | 350 |
| Number Of Female Beneficiaries | 1771 |
| Number Of Male Beneficiaries | 1051 |
| Number Of Non Hispanic White Beneficiaries | 2547 |
| Number Of Black or African American Beneficiaries | 149 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | 43 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2076 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 746 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.409 |