| National Provider Identifier [NPI]: | 1235155318 |
| Last Name Of The Provider | GUERRERO |
| First Name Of The Provider | ETHELWOLDO |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 151 E WEBSTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLUSA |
| Zip Code Of The Provider | 959322949 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3400 |
| Number Of Medicare Beneficiaries | 513 |
| Total Submitted Charge Amount | 381883 |
| Total Medicare Allowed Amount | 218838.05 |
| Total Medicare Payment Amount | 153598.15 |
| Total Medicare Standardized Payment Amount | 149875.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1133 |
| Number Of Medicare Beneficiaries With Drug Services | 248 |
| Total Drug Submitted ChargeAmount | 32937 |
| Total Drug Medicare AllowedAmount | 18054.01 |
| Total Drug Medicare PaymentAmount | 15446.19 |
| Total Drug Medicare Standardized Payment Amount | 15446.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2267 |
| Number Of Medicare Beneficiaries With Medical Services | 513 |
| Total Medical Submitted Charge Amount | 348946 |
| Total Medical Medicare Allowed Amount | 200784.04 |
| Total Medical Medicare Payment Amount | 138151.96 |
| Total Medical Medicare Standardized Payment Amount | 134429.72 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 227 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 431 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.18 |