| National Provider Identifier [NPI]: | 1205867595 |
| Last Name Of The Provider | FLORES |
| First Name Of The Provider | ILDEFONZO |
| 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 | 1520 E SAN PEDRO DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LAREDO |
| Zip Code Of The Provider | 78041 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 6606 |
| Number Of Medicare Beneficiaries | 450 |
| Total Submitted Charge Amount | 343436.65 |
| Total Medicare Allowed Amount | 240339.78 |
| Total Medicare Payment Amount | 169516.94 |
| Total Medicare Standardized Payment Amount | 177547.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 3278 |
| Number Of Medicare Beneficiaries With Drug Services | 233 |
| Total Drug Submitted ChargeAmount | 30888.75 |
| Total Drug Medicare AllowedAmount | 4732.69 |
| Total Drug Medicare PaymentAmount | 3606.44 |
| Total Drug Medicare Standardized Payment Amount | 3606.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3328 |
| Number Of Medicare Beneficiaries With Medical Services | 448 |
| Total Medical Submitted Charge Amount | 312547.9 |
| Total Medical Medicare Allowed Amount | 235607.09 |
| Total Medical Medicare Payment Amount | 165910.5 |
| Total Medical Medicare Standardized Payment Amount | 173941.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 276 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 411 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 247 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8863 |