| National Provider Identifier [NPI]: | 1598726036 |
| Last Name Of The Provider | LIVINGSTON |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| 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 | 256 |
| Number Of Services | 3261 |
| Number Of Medicare Beneficiaries | 1699 |
| Total Submitted Charge Amount | 1144891 |
| Total Medicare Allowed Amount | 232695.74 |
| Total Medicare Payment Amount | 180209.24 |
| Total Medicare Standardized Payment Amount | 183418.82 |
| 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 | 256 |
| Number Of Medical Services | 3261 |
| Number Of Medicare Beneficiaries With Medical Services | 1699 |
| Total Medical Submitted Charge Amount | 1144891 |
| Total Medical Medicare Allowed Amount | 232695.74 |
| Total Medical Medicare Payment Amount | 180209.24 |
| Total Medical Medicare Standardized Payment Amount | 183418.82 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 484 |
| Number Of Beneficiaries Age 65 to 74 | 543 |
| Number Of Beneficiaries Age 75 to 84 | 443 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 913 |
| Number Of Male Beneficiaries | 786 |
| Number Of Non Hispanic White Beneficiaries | 1199 |
| Number Of Black or African American Beneficiaries | 280 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 175 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 517 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 3.056 |