| National Provider Identifier [NPI]: | 1376510685 |
| Last Name Of The Provider | LANE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295900 |
| 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 | 173 |
| Number Of Services | 54862 |
| Number Of Medicare Beneficiaries | 3372 |
| Total Submitted Charge Amount | 2487327.62 |
| Total Medicare Allowed Amount | 672105.68 |
| Total Medicare Payment Amount | 522852.52 |
| Total Medicare Standardized Payment Amount | 560515.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 50023 |
| Number Of Medicare Beneficiaries With Drug Services | 465 |
| Total Drug Submitted ChargeAmount | 28716.5 |
| Total Drug Medicare AllowedAmount | 11287.25 |
| Total Drug Medicare PaymentAmount | 8719.14 |
| Total Drug Medicare Standardized Payment Amount | 8719.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 4839 |
| Number Of Medicare Beneficiaries With Medical Services | 3372 |
| Total Medical Submitted Charge Amount | 2458611.12 |
| Total Medical Medicare Allowed Amount | 660818.43 |
| Total Medical Medicare Payment Amount | 514133.38 |
| Total Medical Medicare Standardized Payment Amount | 551796 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 570 |
| Number Of Beneficiaries Age 65 to 74 | 1267 |
| Number Of Beneficiaries Age 75 to 84 | 1016 |
| Number Of Beneficiaries Age Greater 84 | 519 |
| Number Of Female Beneficiaries | 1841 |
| Number Of Male Beneficiaries | 1531 |
| Number Of Non Hispanic White Beneficiaries | 2110 |
| Number Of Black or African American Beneficiaries | 124 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 1079 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2602 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 770 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1246 |