| National Provider Identifier [NPI]: | 1225069859 |
| Last Name Of The Provider | CERVANTES |
| First Name Of The Provider | MARGO |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| 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 | 146 |
| Number Of Services | 7240 |
| Number Of Medicare Beneficiaries | 1669 |
| Total Submitted Charge Amount | 645861.72 |
| Total Medicare Allowed Amount | 160636.23 |
| Total Medicare Payment Amount | 119277.05 |
| Total Medicare Standardized Payment Amount | 128997.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5066 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 8563.12 |
| Total Drug Medicare AllowedAmount | 2547.28 |
| Total Drug Medicare PaymentAmount | 1876.34 |
| Total Drug Medicare Standardized Payment Amount | 1876.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 2174 |
| Number Of Medicare Beneficiaries With Medical Services | 1668 |
| Total Medical Submitted Charge Amount | 637298.6 |
| Total Medical Medicare Allowed Amount | 158088.95 |
| Total Medical Medicare Payment Amount | 117400.71 |
| Total Medical Medicare Standardized Payment Amount | 127120.88 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 404 |
| Number Of Beneficiaries Age 65 to 74 | 622 |
| Number Of Beneficiaries Age 75 to 84 | 412 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 1026 |
| Number Of Male Beneficiaries | 643 |
| Number Of Non Hispanic White Beneficiaries | 821 |
| Number Of Black or African American Beneficiaries | 159 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 647 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 537 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1736 |