| National Provider Identifier [NPI]: | 1205139029 |
| Last Name Of The Provider | GUERRERO |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | RD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5107 MEDICAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782294801 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Registered Dietician/Nutrition Professional |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 1252 |
| Number Of Medicare Beneficiaries | 346 |
| Total Submitted Charge Amount | 47255 |
| Total Medicare Allowed Amount | 29461.98 |
| Total Medicare Payment Amount | 28021.83 |
| Total Medicare Standardized Payment Amount | 13247.02 |
| 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 | 7 |
| Number Of Medical Services | 1252 |
| Number Of Medicare Beneficiaries With Medical Services | 346 |
| Total Medical Submitted Charge Amount | 47255 |
| Total Medical Medicare Allowed Amount | 29461.98 |
| Total Medical Medicare Payment Amount | 28021.83 |
| Total Medical Medicare Standardized Payment Amount | 13247.02 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | 131 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 191 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.768 |