| National Provider Identifier [NPI]: | 1114016060 |
| Last Name Of The Provider | ESLAVA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1711 N. MCKENZIE STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | FOLEY |
| Zip Code Of The Provider | 36535 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 4320 |
| Number Of Medicare Beneficiaries | 613 |
| Total Submitted Charge Amount | 756665 |
| Total Medicare Allowed Amount | 283057.18 |
| Total Medicare Payment Amount | 208956.18 |
| Total Medicare Standardized Payment Amount | 229428.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1243 |
| Number Of Medicare Beneficiaries With Drug Services | 367 |
| Total Drug Submitted ChargeAmount | 62126 |
| Total Drug Medicare AllowedAmount | 25266.65 |
| Total Drug Medicare PaymentAmount | 19543.82 |
| Total Drug Medicare Standardized Payment Amount | 19543.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 3077 |
| Number Of Medicare Beneficiaries With Medical Services | 612 |
| Total Medical Submitted Charge Amount | 694539 |
| Total Medical Medicare Allowed Amount | 257790.53 |
| Total Medical Medicare Payment Amount | 189412.36 |
| Total Medical Medicare Standardized Payment Amount | 209884.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 582 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 544 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0714 |