| National Provider Identifier [NPI]: | 1831132711 |
| Last Name Of The Provider | PALACIOS |
| First Name Of The Provider | GUILLERMO |
| 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 | 3501 JOHNSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOLLYWOOD |
| Zip Code Of The Provider | 330215421 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 190 |
| Number Of Services | 8109 |
| Number Of Medicare Beneficiaries | 4285 |
| Total Submitted Charge Amount | 1406656 |
| Total Medicare Allowed Amount | 233248.43 |
| Total Medicare Payment Amount | 177395.04 |
| Total Medicare Standardized Payment Amount | 167321.06 |
| 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 | 190 |
| Number Of Medical Services | 8109 |
| Number Of Medicare Beneficiaries With Medical Services | 4285 |
| Total Medical Submitted Charge Amount | 1406656 |
| Total Medical Medicare Allowed Amount | 233248.43 |
| Total Medical Medicare Payment Amount | 177395.04 |
| Total Medical Medicare Standardized Payment Amount | 167321.06 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 702 |
| Number Of Beneficiaries Age 65 to 74 | 1005 |
| Number Of Beneficiaries Age 75 to 84 | 1168 |
| Number Of Beneficiaries Age Greater 84 | 1410 |
| Number Of Female Beneficiaries | 2585 |
| Number Of Male Beneficiaries | 1700 |
| Number Of Non Hispanic White Beneficiaries | 2895 |
| Number Of Black or African American Beneficiaries | 725 |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 539 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 71 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2666 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1619 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.3891 |