| National Provider Identifier [NPI]: | 1386750123 |
| Last Name Of The Provider | GUTIERREZ |
| First Name Of The Provider | RICARDO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 S 17TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DONNA |
| Zip Code Of The Provider | 785373438 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 1740 |
| Number Of Medicare Beneficiaries | 445 |
| Total Submitted Charge Amount | 116872.04 |
| Total Medicare Allowed Amount | 50736.96 |
| Total Medicare Payment Amount | 40774.38 |
| Total Medicare Standardized Payment Amount | 48920.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 1187.3 |
| Total Drug Medicare AllowedAmount | 551.76 |
| Total Drug Medicare PaymentAmount | 488.3 |
| Total Drug Medicare Standardized Payment Amount | 488.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1614 |
| Number Of Medicare Beneficiaries With Medical Services | 445 |
| Total Medical Submitted Charge Amount | 115684.74 |
| Total Medical Medicare Allowed Amount | 50185.2 |
| Total Medical Medicare Payment Amount | 40286.08 |
| Total Medical Medicare Standardized Payment Amount | 48432.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 175 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 253 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 267 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 238 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6991 |