| National Provider Identifier [NPI]: | 1801813266 |
| Last Name Of The Provider | BEAN |
| First Name Of The Provider | GREGG |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7703 FLOYD CURL DR |
| Street Address 2 Of The Provider | MC7977 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293901 |
| 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 | 124 |
| Number Of Services | 5246 |
| Number Of Medicare Beneficiaries | 2079 |
| Total Submitted Charge Amount | 425772 |
| Total Medicare Allowed Amount | 139088.26 |
| Total Medicare Payment Amount | 102332.2 |
| Total Medicare Standardized Payment Amount | 111438.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1292 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2324 |
| Total Drug Medicare AllowedAmount | 699.35 |
| Total Drug Medicare PaymentAmount | 525.06 |
| Total Drug Medicare Standardized Payment Amount | 525.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 3954 |
| Number Of Medicare Beneficiaries With Medical Services | 2079 |
| Total Medical Submitted Charge Amount | 423448 |
| Total Medical Medicare Allowed Amount | 138388.91 |
| Total Medical Medicare Payment Amount | 101807.14 |
| Total Medical Medicare Standardized Payment Amount | 110913.6 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 576 |
| Number Of Beneficiaries Age 65 to 74 | 823 |
| Number Of Beneficiaries Age 75 to 84 | 514 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 1291 |
| Number Of Male Beneficiaries | 788 |
| Number Of Non Hispanic White Beneficiaries | 1129 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 788 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 672 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7069 |