| National Provider Identifier [NPI]: | 1720066921 |
| Last Name Of The Provider | BLAKE |
| First Name Of The Provider | LINDSEY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3061 S MARYLAND PKWY |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891092298 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 190 |
| Number Of Services | 5313 |
| Number Of Medicare Beneficiaries | 3327 |
| Total Submitted Charge Amount | 584439 |
| Total Medicare Allowed Amount | 174061.66 |
| Total Medicare Payment Amount | 133878.88 |
| Total Medicare Standardized Payment Amount | 129943.89 |
| 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 | 190 |
| Number Of Medical Services | 5313 |
| Number Of Medicare Beneficiaries With Medical Services | 3327 |
| Total Medical Submitted Charge Amount | 584439 |
| Total Medical Medicare Allowed Amount | 174061.66 |
| Total Medical Medicare Payment Amount | 133878.88 |
| Total Medical Medicare Standardized Payment Amount | 129943.89 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 688 |
| Number Of Beneficiaries Age 65 to 74 | 1162 |
| Number Of Beneficiaries Age 75 to 84 | 979 |
| Number Of Beneficiaries Age Greater 84 | 498 |
| Number Of Female Beneficiaries | 1768 |
| Number Of Male Beneficiaries | 1559 |
| Number Of Non Hispanic White Beneficiaries | 2255 |
| Number Of Black or African American Beneficiaries | 470 |
| Number Of AsianPacific Islander Beneficiaries | 172 |
| Number Of Hispanic Beneficiaries | 358 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2398 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 929 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.3132 |