| National Provider Identifier [NPI]: | 1285706143 |
| Last Name Of The Provider | VILLANUEVA |
| First Name Of The Provider | SALVADOR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | AVENIDA 65 DE INFANTERIA CARRETERA 3 KM. 8.3 |
| Street Address 2 Of The Provider | HOSPITAL UPR |
| City Of The Provider | CAROLINA |
| Zip Code Of The Provider | 00984 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 612 |
| Number Of Medicare Beneficiaries | 546 |
| Total Submitted Charge Amount | 826498 |
| Total Medicare Allowed Amount | 93293.88 |
| Total Medicare Payment Amount | 70965.39 |
| Total Medicare Standardized Payment Amount | 69017.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 612 |
| Number Of Medicare Beneficiaries With Medical Services | 546 |
| Total Medical Submitted Charge Amount | 826498 |
| Total Medical Medicare Allowed Amount | 93293.88 |
| Total Medical Medicare Payment Amount | 70965.39 |
| Total Medical Medicare Standardized Payment Amount | 69017.69 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 403 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 339 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1348 |