| National Provider Identifier [NPI]: | 1023013828 |
| Last Name Of The Provider | RAMON |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13737 NOEL ROAD |
| Street Address 2 Of The Provider | STE 1400 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752402004 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 719 |
| Number Of Medicare Beneficiaries | 200 |
| Total Submitted Charge Amount | 883849.05 |
| Total Medicare Allowed Amount | 81092.46 |
| Total Medicare Payment Amount | 61862.78 |
| Total Medicare Standardized Payment Amount | 59761.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 260 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1594.35 |
| Total Drug Medicare AllowedAmount | 512.45 |
| Total Drug Medicare PaymentAmount | 401.74 |
| Total Drug Medicare Standardized Payment Amount | 401.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 459 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 882254.7 |
| Total Medical Medicare Allowed Amount | 80580.01 |
| Total Medical Medicare Payment Amount | 61461.04 |
| Total Medical Medicare Standardized Payment Amount | 59359.85 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 92 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1167 |