| National Provider Identifier [NPI]: | 1790751576 |
| Last Name Of The Provider | ILORETA |
| First Name Of The Provider | ALFREDO |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1516 SW 6TH AVE |
| Street Address 2 Of The Provider | STE 1 |
| City Of The Provider | TOPEKA |
| Zip Code Of The Provider | 666062729 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 5727 |
| Number Of Medicare Beneficiaries | 1167 |
| Total Submitted Charge Amount | 1569335 |
| Total Medicare Allowed Amount | 376606.13 |
| Total Medicare Payment Amount | 278748.12 |
| Total Medicare Standardized Payment Amount | 301645.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 50950 |
| Total Drug Medicare AllowedAmount | 15810.1 |
| Total Drug Medicare PaymentAmount | 12031.55 |
| Total Drug Medicare Standardized Payment Amount | 12031.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 5639 |
| Number Of Medicare Beneficiaries With Medical Services | 1166 |
| Total Medical Submitted Charge Amount | 1518385 |
| Total Medical Medicare Allowed Amount | 360796.03 |
| Total Medical Medicare Payment Amount | 266716.57 |
| Total Medical Medicare Standardized Payment Amount | 289613.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 458 |
| Number Of Beneficiaries Age 75 to 84 | 401 |
| Number Of Beneficiaries Age Greater 84 | 193 |
| Number Of Female Beneficiaries | 278 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 1005 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1026 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2477 |