| National Provider Identifier [NPI]: | 1447214861 |
| Last Name Of The Provider | HIDALGO |
| First Name Of The Provider | IGNACIO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1706 E SEMORAN BLVD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | APOPKA |
| Zip Code Of The Provider | 327035651 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 15499 |
| Number Of Medicare Beneficiaries | 39 |
| Total Submitted Charge Amount | 159461 |
| Total Medicare Allowed Amount | 115300.83 |
| Total Medicare Payment Amount | 87988.09 |
| Total Medicare Standardized Payment Amount | 88322.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15248 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 107416 |
| Total Drug Medicare AllowedAmount | 83310.17 |
| Total Drug Medicare PaymentAmount | 65181.85 |
| Total Drug Medicare Standardized Payment Amount | 65181.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 251 |
| Number Of Medicare Beneficiaries With Medical Services | 39 |
| Total Medical Submitted Charge Amount | 52045 |
| Total Medical Medicare Allowed Amount | 31990.66 |
| Total Medical Medicare Payment Amount | 22806.24 |
| Total Medical Medicare Standardized Payment Amount | 23141.05 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 15 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 31 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.4963 |