| National Provider Identifier [NPI]: | 1467588780 |
| Last Name Of The Provider | ROMERO |
| First Name Of The Provider | MIRIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1520 SAN PABLO ST |
| Street Address 2 Of The Provider | LOWER LEVEL, SUITE 1600 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900335310 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 1014 |
| Number Of Medicare Beneficiaries | 597 |
| Total Submitted Charge Amount | 203772 |
| Total Medicare Allowed Amount | 57564.2 |
| Total Medicare Payment Amount | 42120.67 |
| Total Medicare Standardized Payment Amount | 40575.14 |
| 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 | 50 |
| Number Of Medical Services | 1014 |
| Number Of Medicare Beneficiaries With Medical Services | 597 |
| Total Medical Submitted Charge Amount | 203772 |
| Total Medical Medicare Allowed Amount | 57564.2 |
| Total Medical Medicare Payment Amount | 42120.67 |
| Total Medical Medicare Standardized Payment Amount | 40575.14 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 268 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | 288 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 76 |
| Number Of Hispanic Beneficiaries | 182 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 266 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.7133 |