| National Provider Identifier [NPI]: | 1124135108 |
| Last Name Of The Provider | LOREDO |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7703 FLOYD CURL DR |
| Street Address 2 Of The Provider | MC 7977 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293901 |
| 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 | 76 |
| Number Of Services | 4289 |
| Number Of Medicare Beneficiaries | 1519 |
| Total Submitted Charge Amount | 318812 |
| Total Medicare Allowed Amount | 103928.49 |
| Total Medicare Payment Amount | 77908.9 |
| Total Medicare Standardized Payment Amount | 85264.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1673 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 2411 |
| Total Drug Medicare AllowedAmount | 834.94 |
| Total Drug Medicare PaymentAmount | 654.63 |
| Total Drug Medicare Standardized Payment Amount | 654.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 2616 |
| Number Of Medicare Beneficiaries With Medical Services | 1519 |
| Total Medical Submitted Charge Amount | 316401 |
| Total Medical Medicare Allowed Amount | 103093.55 |
| Total Medical Medicare Payment Amount | 77254.27 |
| Total Medical Medicare Standardized Payment Amount | 84609.58 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 439 |
| Number Of Beneficiaries Age 65 to 74 | 597 |
| Number Of Beneficiaries Age 75 to 84 | 346 |
| Number Of Beneficiaries Age Greater 84 | 137 |
| Number Of Female Beneficiaries | 935 |
| Number Of Male Beneficiaries | 584 |
| Number Of Non Hispanic White Beneficiaries | 827 |
| Number Of Black or African American Beneficiaries | 74 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 580 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1044 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 475 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6897 |