| National Provider Identifier [NPI]: | 1326188194 |
| Last Name Of The Provider | PORRES |
| First Name Of The Provider | FELIPE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3302 W GOLF COURSE RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MIDLAND |
| Zip Code Of The Provider | 797035110 |
| 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 | 25 |
| Number Of Services | 4536 |
| Number Of Medicare Beneficiaries | 774 |
| Total Submitted Charge Amount | 2481950.5 |
| Total Medicare Allowed Amount | 933827.18 |
| Total Medicare Payment Amount | 707915.46 |
| Total Medicare Standardized Payment Amount | 737949.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 875 |
| Total Drug Medicare AllowedAmount | 300.3 |
| Total Drug Medicare PaymentAmount | 285.94 |
| Total Drug Medicare Standardized Payment Amount | 285.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 4501 |
| Number Of Medicare Beneficiaries With Medical Services | 774 |
| Total Medical Submitted Charge Amount | 2481075.5 |
| Total Medical Medicare Allowed Amount | 933526.88 |
| Total Medical Medicare Payment Amount | 707629.52 |
| Total Medical Medicare Standardized Payment Amount | 737663.19 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 275 |
| Number Of Beneficiaries Age 65 to 74 | 227 |
| Number Of Beneficiaries Age 75 to 84 | 198 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 392 |
| Number Of Non Hispanic White Beneficiaries | 404 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 286 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 530 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 244 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 4.0308 |