| National Provider Identifier [NPI]: | 1134304181 |
| Last Name Of The Provider | PACHECO |
| First Name Of The Provider | DANIEL |
| 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 | 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 | 202 |
| Number Of Services | 6467 |
| Number Of Medicare Beneficiaries | 2675 |
| Total Submitted Charge Amount | 515258.7 |
| Total Medicare Allowed Amount | 143330.18 |
| Total Medicare Payment Amount | 108205.36 |
| Total Medicare Standardized Payment Amount | 114579.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2137 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2043.67 |
| Total Drug Medicare AllowedAmount | 421.14 |
| Total Drug Medicare PaymentAmount | 299.5 |
| Total Drug Medicare Standardized Payment Amount | 299.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 200 |
| Number Of Medical Services | 4330 |
| Number Of Medicare Beneficiaries With Medical Services | 2675 |
| Total Medical Submitted Charge Amount | 513215.03 |
| Total Medical Medicare Allowed Amount | 142909.04 |
| Total Medical Medicare Payment Amount | 107905.86 |
| Total Medical Medicare Standardized Payment Amount | 114280.01 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 700 |
| Number Of Beneficiaries Age 65 to 74 | 917 |
| Number Of Beneficiaries Age 75 to 84 | 696 |
| Number Of Beneficiaries Age Greater 84 | 362 |
| Number Of Female Beneficiaries | 1516 |
| Number Of Male Beneficiaries | 1159 |
| Number Of Non Hispanic White Beneficiaries | 1152 |
| Number Of Black or African American Beneficiaries | 298 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 1186 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1577 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1098 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.5984 |