| National Provider Identifier [NPI]: | 1851300891 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | ROBERTO |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2510 E MAIN ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | ALICE |
| Zip Code Of The Provider | 783324187 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 16971 |
| Number Of Medicare Beneficiaries | 1406 |
| Total Submitted Charge Amount | 1721854.08 |
| Total Medicare Allowed Amount | 975250.05 |
| Total Medicare Payment Amount | 708725.73 |
| Total Medicare Standardized Payment Amount | 752365.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1498 |
| Number Of Medicare Beneficiaries With Drug Services | 556 |
| Total Drug Submitted ChargeAmount | 33752.75 |
| Total Drug Medicare AllowedAmount | 8097.38 |
| Total Drug Medicare PaymentAmount | 7489.54 |
| Total Drug Medicare Standardized Payment Amount | 7489.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 15473 |
| Number Of Medicare Beneficiaries With Medical Services | 1406 |
| Total Medical Submitted Charge Amount | 1688101.33 |
| Total Medical Medicare Allowed Amount | 967152.67 |
| Total Medical Medicare Payment Amount | 701236.19 |
| Total Medical Medicare Standardized Payment Amount | 744875.84 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 368 |
| Number Of Beneficiaries Age 65 to 74 | 468 |
| Number Of Beneficiaries Age 75 to 84 | 403 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 818 |
| Number Of Male Beneficiaries | 588 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1132 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 563 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 843 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6534 |