| National Provider Identifier [NPI]: | 1558360909 |
| Last Name Of The Provider | BUNDY |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| 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 | 191 |
| Number Of Services | 30280 |
| Number Of Medicare Beneficiaries | 4036 |
| Total Submitted Charge Amount | 11233432.32 |
| Total Medicare Allowed Amount | 559992.93 |
| Total Medicare Payment Amount | 418307.35 |
| Total Medicare Standardized Payment Amount | 460624.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 23014 |
| Number Of Medicare Beneficiaries With Drug Services | 395 |
| Total Drug Submitted ChargeAmount | 87131.36 |
| Total Drug Medicare AllowedAmount | 24661.6 |
| Total Drug Medicare PaymentAmount | 19309.46 |
| Total Drug Medicare Standardized Payment Amount | 19309.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 187 |
| Number Of Medical Services | 7266 |
| Number Of Medicare Beneficiaries With Medical Services | 4036 |
| Total Medical Submitted Charge Amount | 11146300.96 |
| Total Medical Medicare Allowed Amount | 535331.33 |
| Total Medical Medicare Payment Amount | 398997.89 |
| Total Medical Medicare Standardized Payment Amount | 441314.96 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 465 |
| Number Of Beneficiaries Age 65 to 74 | 1909 |
| Number Of Beneficiaries Age 75 to 84 | 1173 |
| Number Of Beneficiaries Age Greater 84 | 489 |
| Number Of Female Beneficiaries | 2388 |
| Number Of Male Beneficiaries | 1648 |
| Number Of Non Hispanic White Beneficiaries | 3253 |
| Number Of Black or African American Beneficiaries | 336 |
| Number Of AsianPacific Islander Beneficiaries | 179 |
| Number Of Hispanic Beneficiaries | 193 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2894 |