| National Provider Identifier [NPI]: | 1366652729 |
| Last Name Of The Provider | DYKE |
| First Name Of The Provider | ALLEN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 815 PENNSYLVANIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761042224 |
| 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 | 176 |
| Number Of Services | 5003 |
| Number Of Medicare Beneficiaries | 3520 |
| Total Submitted Charge Amount | 680822.49 |
| Total Medicare Allowed Amount | 174137.26 |
| Total Medicare Payment Amount | 130849.26 |
| Total Medicare Standardized Payment Amount | 134616.91 |
| 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 | 176 |
| Number Of Medical Services | 5003 |
| Number Of Medicare Beneficiaries With Medical Services | 3520 |
| Total Medical Submitted Charge Amount | 680822.49 |
| Total Medical Medicare Allowed Amount | 174137.26 |
| Total Medical Medicare Payment Amount | 130849.26 |
| Total Medical Medicare Standardized Payment Amount | 134616.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 763 |
| Number Of Beneficiaries Age 65 to 74 | 1258 |
| Number Of Beneficiaries Age 75 to 84 | 918 |
| Number Of Beneficiaries Age Greater 84 | 581 |
| Number Of Female Beneficiaries | 2030 |
| Number Of Male Beneficiaries | 1490 |
| Number Of Non Hispanic White Beneficiaries | 2632 |
| Number Of Black or African American Beneficiaries | 481 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 314 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2526 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 994 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.4668 |