| National Provider Identifier [NPI]: | 1972579993 |
| Last Name Of The Provider | ANDERSEN |
| First Name Of The Provider | GARRETT |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295900 |
| 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 | 146 |
| Number Of Services | 66358 |
| Number Of Medicare Beneficiaries | 3428 |
| Total Submitted Charge Amount | 2906326.72 |
| Total Medicare Allowed Amount | 764396.44 |
| Total Medicare Payment Amount | 594852.67 |
| Total Medicare Standardized Payment Amount | 640857.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 61391 |
| Number Of Medicare Beneficiaries With Drug Services | 668 |
| Total Drug Submitted ChargeAmount | 42645 |
| Total Drug Medicare AllowedAmount | 18442.17 |
| Total Drug Medicare PaymentAmount | 14153.01 |
| Total Drug Medicare Standardized Payment Amount | 14153.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 4967 |
| Number Of Medicare Beneficiaries With Medical Services | 3425 |
| Total Medical Submitted Charge Amount | 2863681.72 |
| Total Medical Medicare Allowed Amount | 745954.27 |
| Total Medical Medicare Payment Amount | 580699.66 |
| Total Medical Medicare Standardized Payment Amount | 626704.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 448 |
| Number Of Beneficiaries Age 65 to 74 | 1610 |
| Number Of Beneficiaries Age 75 to 84 | 997 |
| Number Of Beneficiaries Age Greater 84 | 373 |
| Number Of Female Beneficiaries | 2055 |
| Number Of Male Beneficiaries | 1373 |
| Number Of Non Hispanic White Beneficiaries | 2348 |
| Number Of Black or African American Beneficiaries | 259 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 735 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2910 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 518 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5785 |