| National Provider Identifier [NPI]: | 1295742146 |
| Last Name Of The Provider | GARCIA-DAVALOS |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6262 MC PHERSON ROAD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | LAREDO |
| Zip Code Of The Provider | 780416183 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2762 |
| Number Of Medicare Beneficiaries | 1044 |
| Total Submitted Charge Amount | 820232 |
| Total Medicare Allowed Amount | 359417.34 |
| Total Medicare Payment Amount | 260082.81 |
| Total Medicare Standardized Payment Amount | 275127.57 |
| 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 | 43 |
| Number Of Medical Services | 2762 |
| Number Of Medicare Beneficiaries With Medical Services | 1044 |
| Total Medical Submitted Charge Amount | 820232 |
| Total Medical Medicare Allowed Amount | 359417.34 |
| Total Medical Medicare Payment Amount | 260082.81 |
| Total Medical Medicare Standardized Payment Amount | 275127.57 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 427 |
| Number Of Beneficiaries Age 75 to 84 | 369 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 675 |
| Number Of Male Beneficiaries | 369 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 995 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 701 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3107 |