| National Provider Identifier [NPI]: | 1255335881 |
| Last Name Of The Provider | QUERALT |
| First Name Of The Provider | YVONNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| 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 | 170 |
| Number Of Services | 9706 |
| Number Of Medicare Beneficiaries | 2547 |
| Total Submitted Charge Amount | 766231.2 |
| Total Medicare Allowed Amount | 216467.67 |
| Total Medicare Payment Amount | 168656.61 |
| Total Medicare Standardized Payment Amount | 171682.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 5987 |
| Number Of Medicare Beneficiaries With Drug Services | 183 |
| Total Drug Submitted ChargeAmount | 49168.7 |
| Total Drug Medicare AllowedAmount | 13182.99 |
| Total Drug Medicare PaymentAmount | 9865.67 |
| Total Drug Medicare Standardized Payment Amount | 9865.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 3719 |
| Number Of Medicare Beneficiaries With Medical Services | 2544 |
| Total Medical Submitted Charge Amount | 717062.5 |
| Total Medical Medicare Allowed Amount | 203284.68 |
| Total Medical Medicare Payment Amount | 158790.94 |
| Total Medical Medicare Standardized Payment Amount | 161817.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 387 |
| Number Of Beneficiaries Age 65 to 74 | 1065 |
| Number Of Beneficiaries Age 75 to 84 | 727 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1631 |
| Number Of Male Beneficiaries | 916 |
| Number Of Non Hispanic White Beneficiaries | 2018 |
| Number Of Black or African American Beneficiaries | 174 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 284 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2035 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 512 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.539 |