| National Provider Identifier [NPI]: | 1376516526 |
| Last Name Of The Provider | VILLARREAL |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1121 BELLEVILLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BREWTON |
| Zip Code Of The Provider | 364261505 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 9033 |
| Number Of Medicare Beneficiaries | 464 |
| Total Submitted Charge Amount | 306724.39 |
| Total Medicare Allowed Amount | 226331.12 |
| Total Medicare Payment Amount | 163897.3 |
| Total Medicare Standardized Payment Amount | 177659.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2347 |
| Number Of Medicare Beneficiaries With Drug Services | 266 |
| Total Drug Submitted ChargeAmount | 20366.25 |
| Total Drug Medicare AllowedAmount | 7931.38 |
| Total Drug Medicare PaymentAmount | 7176.12 |
| Total Drug Medicare Standardized Payment Amount | 7176.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 6686 |
| Number Of Medicare Beneficiaries With Medical Services | 464 |
| Total Medical Submitted Charge Amount | 286358.14 |
| Total Medical Medicare Allowed Amount | 218399.74 |
| Total Medical Medicare Payment Amount | 156721.18 |
| Total Medical Medicare Standardized Payment Amount | 170482.92 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 170 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 335 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 292 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0875 |