| National Provider Identifier [NPI]: | 1104820794 |
| Last Name Of The Provider | MICHEL |
| First Name Of The Provider | ANDREA |
| 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 | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| 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 | 8291 |
| Number Of Medicare Beneficiaries | 4931 |
| Total Submitted Charge Amount | 684623.3 |
| Total Medicare Allowed Amount | 210491.26 |
| Total Medicare Payment Amount | 162892.86 |
| Total Medicare Standardized Payment Amount | 165433.34 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 798 |
| Number Of Beneficiaries Age 65 to 74 | 2004 |
| Number Of Beneficiaries Age 75 to 84 | 1442 |
| Number Of Beneficiaries Age Greater 84 | 687 |
| Number Of Female Beneficiaries | 3281 |
| Number Of Male Beneficiaries | 1650 |
| Number Of Non Hispanic White Beneficiaries | 3686 |
| Number Of Black or African American Beneficiaries | 460 |
| Number Of AsianPacific Islander Beneficiaries | 161 |
| Number Of Hispanic Beneficiaries | 564 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3997 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 934 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6528 |