| National Provider Identifier [NPI]: | 1649274069 |
| Last Name Of The Provider | TREVINO |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| 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 | 183 |
| Number Of Services | 8080 |
| Number Of Medicare Beneficiaries | 2503 |
| Total Submitted Charge Amount | 749324.9 |
| Total Medicare Allowed Amount | 178442.68 |
| Total Medicare Payment Amount | 135784.17 |
| Total Medicare Standardized Payment Amount | 143450.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4020 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 3368.4 |
| Total Drug Medicare AllowedAmount | 962.82 |
| Total Drug Medicare PaymentAmount | 657.74 |
| Total Drug Medicare Standardized Payment Amount | 657.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 4060 |
| Number Of Medicare Beneficiaries With Medical Services | 2503 |
| Total Medical Submitted Charge Amount | 745956.5 |
| Total Medical Medicare Allowed Amount | 177479.86 |
| Total Medical Medicare Payment Amount | 135126.43 |
| Total Medical Medicare Standardized Payment Amount | 142792.54 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 385 |
| Number Of Beneficiaries Age 65 to 74 | 921 |
| Number Of Beneficiaries Age 75 to 84 | 778 |
| Number Of Beneficiaries Age Greater 84 | 419 |
| Number Of Female Beneficiaries | 1507 |
| Number Of Male Beneficiaries | 996 |
| Number Of Non Hispanic White Beneficiaries | 1914 |
| Number Of Black or African American Beneficiaries | 208 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 322 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1965 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 538 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8931 |