| National Provider Identifier [NPI]: | 1174557417 |
| Last Name Of The Provider | ESTRADA |
| First Name Of The Provider | DEOGRACIAS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 DEWEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WISCONSIN RAPIDS |
| Zip Code Of The Provider | 544944714 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 903 |
| Number Of Medicare Beneficiaries | 316 |
| Total Submitted Charge Amount | 138822 |
| Total Medicare Allowed Amount | 73494.42 |
| Total Medicare Payment Amount | 57382.17 |
| Total Medicare Standardized Payment Amount | 59951.28 |
| 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 | 44 |
| Number Of Medical Services | 903 |
| Number Of Medicare Beneficiaries With Medical Services | 316 |
| Total Medical Submitted Charge Amount | 138822 |
| Total Medical Medicare Allowed Amount | 73494.42 |
| Total Medical Medicare Payment Amount | 57382.17 |
| Total Medical Medicare Standardized Payment Amount | 59951.28 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 117 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 300 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 250 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1645 |