| National Provider Identifier [NPI]: | 1013993096 |
| Last Name Of The Provider | MAGNON |
| First Name Of The Provider | ROBERT |
| 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 | 1303 MCCULLOUGH AVE |
| Street Address 2 Of The Provider | SUITE 525 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782125609 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 21682 |
| Number Of Medicare Beneficiaries | 1960 |
| Total Submitted Charge Amount | 700993.76 |
| Total Medicare Allowed Amount | 607994.06 |
| Total Medicare Payment Amount | 430156.75 |
| Total Medicare Standardized Payment Amount | 442097.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 344.92 |
| Total Drug Medicare AllowedAmount | 304.54 |
| Total Drug Medicare PaymentAmount | 208.32 |
| Total Drug Medicare Standardized Payment Amount | 208.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 21628 |
| Number Of Medicare Beneficiaries With Medical Services | 1960 |
| Total Medical Submitted Charge Amount | 700648.84 |
| Total Medical Medicare Allowed Amount | 607689.52 |
| Total Medical Medicare Payment Amount | 429948.43 |
| Total Medical Medicare Standardized Payment Amount | 441888.93 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 826 |
| Number Of Beneficiaries Age 75 to 84 | 714 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 960 |
| Number Of Male Beneficiaries | 1000 |
| Number Of Non Hispanic White Beneficiaries | 1763 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1800 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0155 |