| National Provider Identifier [NPI]: | 1003807439 |
| Last Name Of The Provider | BENSON |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 311 CAMDEN ST |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782152012 |
| 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 | 222 |
| Number Of Services | 4987 |
| Number Of Medicare Beneficiaries | 2271 |
| Total Submitted Charge Amount | 488725.01 |
| Total Medicare Allowed Amount | 137392.46 |
| Total Medicare Payment Amount | 103693.96 |
| Total Medicare Standardized Payment Amount | 109877.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1181 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1342.01 |
| Total Drug Medicare AllowedAmount | 312.43 |
| Total Drug Medicare PaymentAmount | 244.91 |
| Total Drug Medicare Standardized Payment Amount | 244.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 220 |
| Number Of Medical Services | 3806 |
| Number Of Medicare Beneficiaries With Medical Services | 2270 |
| Total Medical Submitted Charge Amount | 487383 |
| Total Medical Medicare Allowed Amount | 137080.03 |
| Total Medical Medicare Payment Amount | 103449.05 |
| Total Medical Medicare Standardized Payment Amount | 109632.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 554 |
| Number Of Beneficiaries Age 65 to 74 | 735 |
| Number Of Beneficiaries Age 75 to 84 | 606 |
| Number Of Beneficiaries Age Greater 84 | 376 |
| Number Of Female Beneficiaries | 1318 |
| Number Of Male Beneficiaries | 953 |
| Number Of Non Hispanic White Beneficiaries | 1030 |
| Number Of Black or African American Beneficiaries | 244 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 959 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1371 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 900 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.6226 |