| National Provider Identifier [NPI]: | 1194778134 |
| Last Name Of The Provider | OLDHAM |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6411 FANNIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770301501 |
| 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 | 8 |
| Number Of Services | 3039 |
| Number Of Medicare Beneficiaries | 1435 |
| Total Submitted Charge Amount | 190902 |
| Total Medicare Allowed Amount | 38275.27 |
| Total Medicare Payment Amount | 29028.74 |
| Total Medicare Standardized Payment Amount | 29178.48 |
| 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 | 8 |
| Number Of Medical Services | 3039 |
| Number Of Medicare Beneficiaries With Medical Services | 1435 |
| Total Medical Submitted Charge Amount | 190902 |
| Total Medical Medicare Allowed Amount | 38275.27 |
| Total Medical Medicare Payment Amount | 29028.74 |
| Total Medical Medicare Standardized Payment Amount | 29178.48 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 405 |
| Number Of Beneficiaries Age 65 to 74 | 496 |
| Number Of Beneficiaries Age 75 to 84 | 379 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 630 |
| Number Of Male Beneficiaries | 805 |
| Number Of Non Hispanic White Beneficiaries | 791 |
| Number Of Black or African American Beneficiaries | 344 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 230 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 992 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 443 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 65 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 2.8058 |