| National Provider Identifier [NPI]: | 1972729507 |
| Last Name Of The Provider | MARES |
| First Name Of The Provider | LUCIO |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 144 FALCON BLVD APT 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAGLE PASS |
| Zip Code Of The Provider | 788525861 |
| 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 | 20 |
| Number Of Services | 2080 |
| Number Of Medicare Beneficiaries | 540 |
| Total Submitted Charge Amount | 210833 |
| Total Medicare Allowed Amount | 115594.95 |
| Total Medicare Payment Amount | 77551.32 |
| Total Medicare Standardized Payment Amount | 99495.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 145 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 2870 |
| Total Drug Medicare AllowedAmount | 1146.15 |
| Total Drug Medicare PaymentAmount | 1107.91 |
| Total Drug Medicare Standardized Payment Amount | 1107.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 1935 |
| Number Of Medicare Beneficiaries With Medical Services | 540 |
| Total Medical Submitted Charge Amount | 207963 |
| Total Medical Medicare Allowed Amount | 114448.8 |
| Total Medical Medicare Payment Amount | 76443.41 |
| Total Medical Medicare Standardized Payment Amount | 98387.35 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 192 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 313 |
| Number Of Male Beneficiaries | 227 |
| Number Of Non Hispanic White Beneficiaries | 26 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 514 |
| 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 | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 404 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5751 |