| National Provider Identifier [NPI]: | 1841249869 |
| Last Name Of The Provider | HOUSTON |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 E DIXIE AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347487601 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 183 |
| Number Of Services | 21700 |
| Number Of Medicare Beneficiaries | 6023 |
| Total Submitted Charge Amount | 1264743 |
| Total Medicare Allowed Amount | 580521.14 |
| Total Medicare Payment Amount | 462558.88 |
| Total Medicare Standardized Payment Amount | 473745.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12504 |
| Number Of Medicare Beneficiaries With Drug Services | 288 |
| Total Drug Submitted ChargeAmount | 48803 |
| Total Drug Medicare AllowedAmount | 8004.28 |
| Total Drug Medicare PaymentAmount | 6088.63 |
| Total Drug Medicare Standardized Payment Amount | 6088.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 9196 |
| Number Of Medicare Beneficiaries With Medical Services | 6016 |
| Total Medical Submitted Charge Amount | 1215940 |
| Total Medical Medicare Allowed Amount | 572516.86 |
| Total Medical Medicare Payment Amount | 456470.25 |
| Total Medical Medicare Standardized Payment Amount | 467657.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 366 |
| Number Of Beneficiaries Age 65 to 74 | 2609 |
| Number Of Beneficiaries Age 75 to 84 | 2187 |
| Number Of Beneficiaries Age Greater 84 | 861 |
| Number Of Female Beneficiaries | 3538 |
| Number Of Male Beneficiaries | 2485 |
| Number Of Non Hispanic White Beneficiaries | 5645 |
| Number Of Black or African American Beneficiaries | 195 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 108 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5489 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 534 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5565 |