| National Provider Identifier [NPI]: | 1457477226 |
| Last Name Of The Provider | HERRERA |
| First Name Of The Provider | DESPINA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3336 E CHANDLER HEIGHTS RD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GILBERT |
| Zip Code Of The Provider | 852984259 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 441 |
| Number Of Medicare Beneficiaries | 148 |
| Total Submitted Charge Amount | 73188.9 |
| Total Medicare Allowed Amount | 35877.4 |
| Total Medicare Payment Amount | 24504.46 |
| Total Medicare Standardized Payment Amount | 25587.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 5273.9 |
| Total Drug Medicare AllowedAmount | 3242.62 |
| Total Drug Medicare PaymentAmount | 3169.49 |
| Total Drug Medicare Standardized Payment Amount | 3169.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 388 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 67915 |
| Total Medical Medicare Allowed Amount | 32634.78 |
| Total Medical Medicare Payment Amount | 21334.97 |
| Total Medical Medicare Standardized Payment Amount | 22417.71 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 115 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7846 |