| National Provider Identifier [NPI]: | 1962433326 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | ANTONIO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | URB MONTEHIEDRA CALLE |
| Street Address 2 Of The Provider | FALCON NO 51 |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 00926 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 5481 |
| Number Of Medicare Beneficiaries | 1743 |
| Total Submitted Charge Amount | 131573.78 |
| Total Medicare Allowed Amount | 129783.29 |
| Total Medicare Payment Amount | 91305.9 |
| Total Medicare Standardized Payment Amount | 124778.91 |
| 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 | 168 |
| Number Of Medical Services | 5481 |
| Number Of Medicare Beneficiaries With Medical Services | 1743 |
| Total Medical Submitted Charge Amount | 131573.78 |
| Total Medical Medicare Allowed Amount | 129783.29 |
| Total Medical Medicare Payment Amount | 91305.9 |
| Total Medical Medicare Standardized Payment Amount | 124778.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 466 |
| Number Of Beneficiaries Age 65 to 74 | 619 |
| Number Of Beneficiaries Age 75 to 84 | 475 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 954 |
| Number Of Male Beneficiaries | 789 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1713 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1642 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.2047 |