| National Provider Identifier [NPI]: | 1710967146 |
| Last Name Of The Provider | RIDOUT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5409 PLAZA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755031662 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 7783 |
| Number Of Medicare Beneficiaries | 2616 |
| Total Submitted Charge Amount | 1611993.53 |
| Total Medicare Allowed Amount | 429493.76 |
| Total Medicare Payment Amount | 329166.18 |
| Total Medicare Standardized Payment Amount | 231060.74 |
| 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 | 18 |
| Number Of Medical Services | 7783 |
| Number Of Medicare Beneficiaries With Medical Services | 2616 |
| Total Medical Submitted Charge Amount | 1611993.53 |
| Total Medical Medicare Allowed Amount | 429493.76 |
| Total Medical Medicare Payment Amount | 329166.18 |
| Total Medical Medicare Standardized Payment Amount | 231060.74 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 1282 |
| Number Of Beneficiaries Age 75 to 84 | 665 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 1507 |
| Number Of Male Beneficiaries | 1109 |
| Number Of Non Hispanic White Beneficiaries | 2105 |
| Number Of Black or African American Beneficiaries | 450 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2008 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 608 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2131 |