| National Provider Identifier [NPI]: | 1265546121 |
| Last Name Of The Provider | BUNKER-HUERTAS |
| First Name Of The Provider | ANTONIO |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3614 W KENNEDY BLVD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336092852 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 3210 |
| Number Of Medicare Beneficiaries | 900 |
| Total Submitted Charge Amount | 674316 |
| Total Medicare Allowed Amount | 348351.38 |
| Total Medicare Payment Amount | 272588.41 |
| Total Medicare Standardized Payment Amount | 230800.85 |
| 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 | 21 |
| Number Of Medical Services | 3210 |
| Number Of Medicare Beneficiaries With Medical Services | 900 |
| Total Medical Submitted Charge Amount | 674316 |
| Total Medical Medicare Allowed Amount | 348351.38 |
| Total Medical Medicare Payment Amount | 272588.41 |
| Total Medical Medicare Standardized Payment Amount | 230800.85 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 139 |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 273 |
| Number Of Beneficiaries Age Greater 84 | 233 |
| Number Of Female Beneficiaries | 528 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | 114 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 391 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 393 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 507 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.7875 |