| National Provider Identifier [NPI]: | 1073796330 |
| Last Name Of The Provider | VILLAROMAN |
| First Name Of The Provider | LEO |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 GOLDER AVE |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | ODESSA |
| Zip Code Of The Provider | 797614411 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1141 |
| Number Of Medicare Beneficiaries | 288 |
| Total Submitted Charge Amount | 239278 |
| Total Medicare Allowed Amount | 100970.9 |
| Total Medicare Payment Amount | 72335.93 |
| Total Medicare Standardized Payment Amount | 76352.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 3060 |
| Total Drug Medicare AllowedAmount | 965.75 |
| Total Drug Medicare PaymentAmount | 945.43 |
| Total Drug Medicare Standardized Payment Amount | 945.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1075 |
| Number Of Medicare Beneficiaries With Medical Services | 288 |
| Total Medical Submitted Charge Amount | 236218 |
| Total Medical Medicare Allowed Amount | 100005.15 |
| Total Medical Medicare Payment Amount | 71390.5 |
| Total Medical Medicare Standardized Payment Amount | 75407.39 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 133 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 134 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3796 |