| National Provider Identifier [NPI]: | 1558341669 |
| Last Name Of The Provider | LABOR |
| First Name Of The Provider | PENNY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 815 PENNSYLVANIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761042224 |
| 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 | 139 |
| Number Of Services | 3377 |
| Number Of Medicare Beneficiaries | 1878 |
| Total Submitted Charge Amount | 331728.09 |
| Total Medicare Allowed Amount | 94004.2 |
| Total Medicare Payment Amount | 75399.39 |
| Total Medicare Standardized Payment Amount | 77588.79 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 315 |
| Number Of Beneficiaries Age 65 to 74 | 723 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 294 |
| Number Of Female Beneficiaries | 1295 |
| Number Of Male Beneficiaries | 583 |
| Number Of Non Hispanic White Beneficiaries | 1470 |
| Number Of Black or African American Beneficiaries | 211 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 150 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1438 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 440 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0653 |