| National Provider Identifier [NPI]: | 1770594764 |
| Last Name Of The Provider | ZAMORA |
| First Name Of The Provider | BELDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2100 E 6TH ST |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 78724 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 478 |
| Number Of Medicare Beneficiaries | 55 |
| Total Submitted Charge Amount | 25165 |
| Total Medicare Allowed Amount | 15310.2 |
| Total Medicare Payment Amount | 9741.45 |
| Total Medicare Standardized Payment Amount | 10105.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1590 |
| Total Drug Medicare AllowedAmount | 259.44 |
| Total Drug Medicare PaymentAmount | 208.55 |
| Total Drug Medicare Standardized Payment Amount | 208.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 390 |
| Number Of Medicare Beneficiaries With Medical Services | 55 |
| Total Medical Submitted Charge Amount | 23575 |
| Total Medical Medicare Allowed Amount | 15050.76 |
| Total Medical Medicare Payment Amount | 9532.9 |
| Total Medical Medicare Standardized Payment Amount | 9896.72 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 32 |
| Number Of Beneficiaries Age 75 to 84 | 11 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9169 |