| National Provider Identifier [NPI]: | 1518995372 |
| Last Name Of The Provider | ORTIZ |
| First Name Of The Provider | SILVESTRE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 506 E SAN ANTONIO STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | VICTORIA |
| Zip Code Of The Provider | 77901 |
| 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 | 290 |
| Number Of Services | 13497 |
| Number Of Medicare Beneficiaries | 4267 |
| Total Submitted Charge Amount | 1311019 |
| Total Medicare Allowed Amount | 378415.55 |
| Total Medicare Payment Amount | 293446.75 |
| Total Medicare Standardized Payment Amount | 306298.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 290 |
| Number Of Medical Services | 13497 |
| Number Of Medicare Beneficiaries With Medical Services | 4267 |
| Total Medical Submitted Charge Amount | 1311019 |
| Total Medical Medicare Allowed Amount | 378415.55 |
| Total Medical Medicare Payment Amount | 293446.75 |
| Total Medical Medicare Standardized Payment Amount | 306298.46 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 895 |
| Number Of Beneficiaries Age 65 to 74 | 1579 |
| Number Of Beneficiaries Age 75 to 84 | 1178 |
| Number Of Beneficiaries Age Greater 84 | 615 |
| Number Of Female Beneficiaries | 2573 |
| Number Of Male Beneficiaries | 1694 |
| Number Of Non Hispanic White Beneficiaries | 2557 |
| Number Of Black or African American Beneficiaries | 295 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 1374 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1450 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7249 |