| National Provider Identifier [NPI]: | 1497780936 |
| Last Name Of The Provider | ELIZONDO |
| First Name Of The Provider | ANDRES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1044 E FRONT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALICE |
| Zip Code Of The Provider | 783327012 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 6749 |
| Number Of Medicare Beneficiaries | 196 |
| Total Submitted Charge Amount | 438645.32 |
| Total Medicare Allowed Amount | 252459.57 |
| Total Medicare Payment Amount | 186304.94 |
| Total Medicare Standardized Payment Amount | 196770.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 408 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 7424.52 |
| Total Drug Medicare AllowedAmount | 375.46 |
| Total Drug Medicare PaymentAmount | 340.57 |
| Total Drug Medicare Standardized Payment Amount | 340.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 6341 |
| Number Of Medicare Beneficiaries With Medical Services | 196 |
| Total Medical Submitted Charge Amount | 431220.8 |
| Total Medical Medicare Allowed Amount | 252084.11 |
| Total Medical Medicare Payment Amount | 185964.37 |
| Total Medical Medicare Standardized Payment Amount | 196430.01 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 96 |
| Number Of Male Beneficiaries | 100 |
| Number Of Non Hispanic White Beneficiaries | 38 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.738 |