| National Provider Identifier [NPI]: | 1043329303 |
| Last Name Of The Provider | VILLALOBOS |
| First Name Of The Provider | EDUARDO |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5000 UNIVERSITY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331462008 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 4969 |
| Number Of Medicare Beneficiaries | 2359 |
| Total Submitted Charge Amount | 2520114 |
| Total Medicare Allowed Amount | 218645.82 |
| Total Medicare Payment Amount | 164485.93 |
| Total Medicare Standardized Payment Amount | 157486.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2054 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 16734 |
| Total Drug Medicare AllowedAmount | 1108.68 |
| Total Drug Medicare PaymentAmount | 862.24 |
| Total Drug Medicare Standardized Payment Amount | 862.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 2915 |
| Number Of Medicare Beneficiaries With Medical Services | 2359 |
| Total Medical Submitted Charge Amount | 2503380 |
| Total Medical Medicare Allowed Amount | 217537.14 |
| Total Medical Medicare Payment Amount | 163623.69 |
| Total Medical Medicare Standardized Payment Amount | 156624.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 307 |
| Number Of Beneficiaries Age 65 to 74 | 750 |
| Number Of Beneficiaries Age 75 to 84 | 752 |
| Number Of Beneficiaries Age Greater 84 | 550 |
| Number Of Female Beneficiaries | 1502 |
| Number Of Male Beneficiaries | 857 |
| Number Of Non Hispanic White Beneficiaries | 835 |
| Number Of Black or African American Beneficiaries | 132 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1362 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1174 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1185 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.0133 |