| National Provider Identifier [NPI]: | 1922017409 |
| Last Name Of The Provider | PATINO |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 837 FM 1960 WEST |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770900000 |
| 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 | 76 |
| Number Of Services | 1359 |
| Number Of Medicare Beneficiaries | 996 |
| Total Submitted Charge Amount | 399338 |
| Total Medicare Allowed Amount | 75795.84 |
| Total Medicare Payment Amount | 54619.5 |
| Total Medicare Standardized Payment Amount | 55494.6 |
| 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 | 76 |
| Number Of Medical Services | 1359 |
| Number Of Medicare Beneficiaries With Medical Services | 996 |
| Total Medical Submitted Charge Amount | 399338 |
| Total Medical Medicare Allowed Amount | 75795.84 |
| Total Medical Medicare Payment Amount | 54619.5 |
| Total Medical Medicare Standardized Payment Amount | 55494.6 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 382 |
| Number Of Beneficiaries Age 75 to 84 | 269 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 522 |
| Number Of Male Beneficiaries | 474 |
| Number Of Non Hispanic White Beneficiaries | 581 |
| Number Of Black or African American Beneficiaries | 246 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 126 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 735 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 1.8117 |