| National Provider Identifier [NPI]: | 1558399816 |
| Last Name Of The Provider | CECCONI |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 414 NAVARRO ST |
| Street Address 2 Of The Provider | SUITE # 900 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782052516 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3909 |
| Number Of Medicare Beneficiaries | 685 |
| Total Submitted Charge Amount | 447789.38 |
| Total Medicare Allowed Amount | 191321.89 |
| Total Medicare Payment Amount | 144212.41 |
| Total Medicare Standardized Payment Amount | 151798.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 628 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 24102 |
| Total Drug Medicare AllowedAmount | 10363.95 |
| Total Drug Medicare PaymentAmount | 8061.2 |
| Total Drug Medicare Standardized Payment Amount | 8061.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 3281 |
| Number Of Medicare Beneficiaries With Medical Services | 685 |
| Total Medical Submitted Charge Amount | 423687.38 |
| Total Medical Medicare Allowed Amount | 180957.94 |
| Total Medical Medicare Payment Amount | 136151.21 |
| Total Medical Medicare Standardized Payment Amount | 143737.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 250 |
| Number Of Beneficiaries Age 75 to 84 | 219 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 525 |
| Number Of Male Beneficiaries | 160 |
| Number Of Non Hispanic White Beneficiaries | 285 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 352 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 448 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 237 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5527 |