| National Provider Identifier [NPI]: | 1790959427 |
| Last Name Of The Provider | TREVINO |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 CALYPSO BAY CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEARLAND |
| Zip Code Of The Provider | 775841742 |
| 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 | 105 |
| Number Of Services | 3986 |
| Number Of Medicare Beneficiaries | 2396 |
| Total Submitted Charge Amount | 306910.99 |
| Total Medicare Allowed Amount | 100516.09 |
| Total Medicare Payment Amount | 76055.28 |
| Total Medicare Standardized Payment Amount | 77347.94 |
| 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 | 105 |
| Number Of Medical Services | 3986 |
| Number Of Medicare Beneficiaries With Medical Services | 2396 |
| Total Medical Submitted Charge Amount | 306910.99 |
| Total Medical Medicare Allowed Amount | 100516.09 |
| Total Medical Medicare Payment Amount | 76055.28 |
| Total Medical Medicare Standardized Payment Amount | 77347.94 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 275 |
| Number Of Beneficiaries Age 65 to 74 | 1047 |
| Number Of Beneficiaries Age 75 to 84 | 725 |
| Number Of Beneficiaries Age Greater 84 | 349 |
| Number Of Female Beneficiaries | 1721 |
| Number Of Male Beneficiaries | 675 |
| Number Of Non Hispanic White Beneficiaries | 604 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 1382 |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 284 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2051 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 345 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6095 |