| National Provider Identifier [NPI]: | 1114978624 |
| Last Name Of The Provider | QUINTERO |
| First Name Of The Provider | VICENTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 493 S SEGUIN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BRAUNFELS |
| Zip Code Of The Provider | 781307642 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 5356 |
| Number Of Medicare Beneficiaries | 876 |
| Total Submitted Charge Amount | 714852 |
| Total Medicare Allowed Amount | 388055.46 |
| Total Medicare Payment Amount | 282735.44 |
| Total Medicare Standardized Payment Amount | 296827.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 236 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 38340 |
| Total Drug Medicare AllowedAmount | 29776.23 |
| Total Drug Medicare PaymentAmount | 23332.77 |
| Total Drug Medicare Standardized Payment Amount | 23332.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 5120 |
| Number Of Medicare Beneficiaries With Medical Services | 876 |
| Total Medical Submitted Charge Amount | 676512 |
| Total Medical Medicare Allowed Amount | 358279.23 |
| Total Medical Medicare Payment Amount | 259402.67 |
| Total Medical Medicare Standardized Payment Amount | 273494.58 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 439 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 387 |
| Number Of Male Beneficiaries | 489 |
| Number Of Non Hispanic White Beneficiaries | 799 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 834 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9629 |