| National Provider Identifier [NPI]: | 1972534345 |
| Last Name Of The Provider | LOCKHART |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 19TH STREET SOUTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 35233 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 8412 |
| Number Of Medicare Beneficiaries | 1977 |
| Total Submitted Charge Amount | 769471 |
| Total Medicare Allowed Amount | 138490.38 |
| Total Medicare Payment Amount | 101563.82 |
| Total Medicare Standardized Payment Amount | 114206.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5796 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 6292 |
| Total Drug Medicare AllowedAmount | 1448.02 |
| Total Drug Medicare PaymentAmount | 881.79 |
| Total Drug Medicare Standardized Payment Amount | 881.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 2616 |
| Number Of Medicare Beneficiaries With Medical Services | 1977 |
| Total Medical Submitted Charge Amount | 763179 |
| Total Medical Medicare Allowed Amount | 137042.36 |
| Total Medical Medicare Payment Amount | 100682.03 |
| Total Medical Medicare Standardized Payment Amount | 113325.19 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 704 |
| Number Of Beneficiaries Age 65 to 74 | 765 |
| Number Of Beneficiaries Age 75 to 84 | 396 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 1026 |
| Number Of Male Beneficiaries | 951 |
| Number Of Non Hispanic White Beneficiaries | 1378 |
| Number Of Black or African American Beneficiaries | 561 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 563 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2624 |