| National Provider Identifier [NPI]: | 1356316855 |
| Last Name Of The Provider | GARCIA-VALENZUELA |
| First Name Of The Provider | ENRIQUE |
| 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 | 8901 W. GOLF ROAD |
| Street Address 2 Of The Provider | 206 |
| City Of The Provider | DES PLAINES |
| Zip Code Of The Provider | 600166850 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 27542 |
| Number Of Medicare Beneficiaries | 1540 |
| Total Submitted Charge Amount | 2997101.39 |
| Total Medicare Allowed Amount | 2840920.93 |
| Total Medicare Payment Amount | 2175437.78 |
| Total Medicare Standardized Payment Amount | 2079350.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 5322 |
| Number Of Medicare Beneficiaries With Drug Services | 447 |
| Total Drug Submitted ChargeAmount | 454714.82 |
| Total Drug Medicare AllowedAmount | 449440.19 |
| Total Drug Medicare PaymentAmount | 346123.41 |
| Total Drug Medicare Standardized Payment Amount | 346123.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 22220 |
| Number Of Medicare Beneficiaries With Medical Services | 1540 |
| Total Medical Submitted Charge Amount | 2542386.57 |
| Total Medical Medicare Allowed Amount | 2391480.74 |
| Total Medical Medicare Payment Amount | 1829314.37 |
| Total Medical Medicare Standardized Payment Amount | 1733227.35 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 550 |
| Number Of Beneficiaries Age 75 to 84 | 549 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 872 |
| Number Of Male Beneficiaries | 668 |
| Number Of Non Hispanic White Beneficiaries | 1242 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 83 |
| Number Of Hispanic Beneficiaries | 161 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4176 |