| National Provider Identifier [NPI]: | 1710970488 |
| Last Name Of The Provider | VILLASIS |
| First Name Of The Provider | TERESITA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 S FRONT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOWAGIAC |
| Zip Code Of The Provider | 490471740 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 201 |
| Number Of Medicare Beneficiaries | 103 |
| Total Submitted Charge Amount | 7338 |
| Total Medicare Allowed Amount | 4507.08 |
| Total Medicare Payment Amount | 3991.74 |
| Total Medicare Standardized Payment Amount | 4164.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 70 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 1428 |
| Total Drug Medicare AllowedAmount | 1117.27 |
| Total Drug Medicare PaymentAmount | 1088.09 |
| Total Drug Medicare Standardized Payment Amount | 1088.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 131 |
| Number Of Medicare Beneficiaries With Medical Services | 95 |
| Total Medical Submitted Charge Amount | 5910 |
| Total Medical Medicare Allowed Amount | 3389.81 |
| Total Medical Medicare Payment Amount | 2903.65 |
| Total Medical Medicare Standardized Payment Amount | 3076.87 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 86 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9898 |