| National Provider Identifier [NPI]: | 1285732875 |
| Last Name Of The Provider | LATONI |
| First Name Of The Provider | DIMITRI |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7400 MENTOR MINTER BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782294404 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 9070 |
| Number Of Medicare Beneficiaries | 1337 |
| Total Submitted Charge Amount | 1274929.5 |
| Total Medicare Allowed Amount | 471202.64 |
| Total Medicare Payment Amount | 368802.51 |
| Total Medicare Standardized Payment Amount | 389055.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 9070 |
| Number Of Medicare Beneficiaries With Medical Services | 1337 |
| Total Medical Submitted Charge Amount | 1274929.5 |
| Total Medical Medicare Allowed Amount | 471202.64 |
| Total Medical Medicare Payment Amount | 368802.51 |
| Total Medical Medicare Standardized Payment Amount | 389055.07 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 238 |
| Number Of Beneficiaries Age 75 to 84 | 434 |
| Number Of Beneficiaries Age Greater 84 | 547 |
| Number Of Female Beneficiaries | 733 |
| Number Of Male Beneficiaries | 604 |
| Number Of Non Hispanic White Beneficiaries | 785 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 454 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 712 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 27 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 2.6176 |