| National Provider Identifier [NPI]: | 1629375928 |
| Last Name Of The Provider | MEDINA |
| First Name Of The Provider | LORENA |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MSPAS-PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 S WOODLAND DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHARR |
| Zip Code Of The Provider | 785775213 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 5872 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 597176.45 |
| Total Medicare Allowed Amount | 153637.17 |
| Total Medicare Payment Amount | 120295.91 |
| Total Medicare Standardized Payment Amount | 142538.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 872 |
| Number Of Medicare Beneficiaries With Drug Services | 108 |
| Total Drug Submitted ChargeAmount | 33135 |
| Total Drug Medicare AllowedAmount | 1420.44 |
| Total Drug Medicare PaymentAmount | 1202.63 |
| Total Drug Medicare Standardized Payment Amount | 1202.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 5000 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 564041.45 |
| Total Medical Medicare Allowed Amount | 152216.73 |
| Total Medical Medicare Payment Amount | 119093.28 |
| Total Medical Medicare Standardized Payment Amount | 141336.13 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 139 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 194 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8064 |