| National Provider Identifier [NPI]: | 1255312450 |
| Last Name Of The Provider | PAGAN-MARIN |
| First Name Of The Provider | HERIBERTO |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8701 BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERRILLVILLE |
| Zip Code Of The Provider | 464107035 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 204 |
| Number Of Services | 6449 |
| Number Of Medicare Beneficiaries | 3111 |
| Total Submitted Charge Amount | 1060173 |
| Total Medicare Allowed Amount | 311270.04 |
| Total Medicare Payment Amount | 240202.95 |
| Total Medicare Standardized Payment Amount | 251920.16 |
| 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 | 204 |
| Number Of Medical Services | 6449 |
| Number Of Medicare Beneficiaries With Medical Services | 3111 |
| Total Medical Submitted Charge Amount | 1060173 |
| Total Medical Medicare Allowed Amount | 311270.04 |
| Total Medical Medicare Payment Amount | 240202.95 |
| Total Medical Medicare Standardized Payment Amount | 251920.16 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 899 |
| Number Of Beneficiaries Age 65 to 74 | 935 |
| Number Of Beneficiaries Age 75 to 84 | 825 |
| Number Of Beneficiaries Age Greater 84 | 452 |
| Number Of Female Beneficiaries | 1845 |
| Number Of Male Beneficiaries | 1266 |
| Number Of Non Hispanic White Beneficiaries | 1032 |
| Number Of Black or African American Beneficiaries | 1918 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 137 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1802 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1309 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.4063 |