| National Provider Identifier [NPI]: | 1689772261 |
| Last Name Of The Provider | VILLALVAZO |
| First Name Of The Provider | ANTONIO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6191 N FRESNO ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937108612 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 21799 |
| Number Of Medicare Beneficiaries | 827 |
| Total Submitted Charge Amount | 1386299.11 |
| Total Medicare Allowed Amount | 909165.2 |
| Total Medicare Payment Amount | 682176.14 |
| Total Medicare Standardized Payment Amount | 656105.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 4975 |
| Number Of Medicare Beneficiaries With Drug Services | 712 |
| Total Drug Submitted ChargeAmount | 62295 |
| Total Drug Medicare AllowedAmount | 16610 |
| Total Drug Medicare PaymentAmount | 14038.84 |
| Total Drug Medicare Standardized Payment Amount | 14038.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 16824 |
| Number Of Medicare Beneficiaries With Medical Services | 827 |
| Total Medical Submitted Charge Amount | 1324004.11 |
| Total Medical Medicare Allowed Amount | 892555.2 |
| Total Medical Medicare Payment Amount | 668137.3 |
| Total Medical Medicare Standardized Payment Amount | 642066.59 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 278 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 451 |
| Number Of Male Beneficiaries | 376 |
| Number Of Non Hispanic White Beneficiaries | 191 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 581 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 694 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 70 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3288 |