| National Provider Identifier [NPI]: | 1881731099 |
| Last Name Of The Provider | TUBB |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295900 |
| 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 | 256 |
| Number Of Services | 21377 |
| Number Of Medicare Beneficiaries | 2513 |
| Total Submitted Charge Amount | 1473125.36 |
| Total Medicare Allowed Amount | 385996.87 |
| Total Medicare Payment Amount | 297913.15 |
| Total Medicare Standardized Payment Amount | 324732.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 17427 |
| Number Of Medicare Beneficiaries With Drug Services | 205 |
| Total Drug Submitted ChargeAmount | 12581 |
| Total Drug Medicare AllowedAmount | 5310.68 |
| Total Drug Medicare PaymentAmount | 4108.13 |
| Total Drug Medicare Standardized Payment Amount | 4108.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 253 |
| Number Of Medical Services | 3950 |
| Number Of Medicare Beneficiaries With Medical Services | 2513 |
| Total Medical Submitted Charge Amount | 1460544.36 |
| Total Medical Medicare Allowed Amount | 380686.19 |
| Total Medical Medicare Payment Amount | 293805.02 |
| Total Medical Medicare Standardized Payment Amount | 320624.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 429 |
| Number Of Beneficiaries Age 65 to 74 | 952 |
| Number Of Beneficiaries Age 75 to 84 | 746 |
| Number Of Beneficiaries Age Greater 84 | 386 |
| Number Of Female Beneficiaries | 1394 |
| Number Of Male Beneficiaries | 1119 |
| Number Of Non Hispanic White Beneficiaries | 1554 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 833 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1902 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 611 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1282 |