| National Provider Identifier [NPI]: | 1629037023 |
| Last Name Of The Provider | OTERO |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 UNIVERSITY SQUARE DRIVE |
| Street Address 2 Of The Provider | RADIOLOGY ASSOCIATES OF TAMPA |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336125513 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 13935 |
| Number Of Medicare Beneficiaries | 4372 |
| Total Submitted Charge Amount | 1678219.75 |
| Total Medicare Allowed Amount | 427728.94 |
| Total Medicare Payment Amount | 319564.81 |
| Total Medicare Standardized Payment Amount | 330986.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7830 |
| Number Of Medicare Beneficiaries With Drug Services | 203 |
| Total Drug Submitted ChargeAmount | 18206.75 |
| Total Drug Medicare AllowedAmount | 4270.03 |
| Total Drug Medicare PaymentAmount | 3204.16 |
| Total Drug Medicare Standardized Payment Amount | 3204.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 187 |
| Number Of Medical Services | 6105 |
| Number Of Medicare Beneficiaries With Medical Services | 4369 |
| Total Medical Submitted Charge Amount | 1660013 |
| Total Medical Medicare Allowed Amount | 423458.91 |
| Total Medical Medicare Payment Amount | 316360.65 |
| Total Medical Medicare Standardized Payment Amount | 327782.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 811 |
| Number Of Beneficiaries Age 65 to 74 | 1660 |
| Number Of Beneficiaries Age 75 to 84 | 1308 |
| Number Of Beneficiaries Age Greater 84 | 593 |
| Number Of Female Beneficiaries | 2589 |
| Number Of Male Beneficiaries | 1783 |
| Number Of Non Hispanic White Beneficiaries | 3279 |
| Number Of Black or African American Beneficiaries | 426 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 551 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1089 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8041 |