| National Provider Identifier [NPI]: | 1790779262 |
| Last Name Of The Provider | GARCIA |
| First Name Of The Provider | FIDEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2014 UNIVERSITY BLVD W |
| Street Address 2 Of The Provider | CREDENTIALING DEPARTMENT |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322172016 |
| 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 | 38 |
| Number Of Services | 5838 |
| Number Of Medicare Beneficiaries | 1412 |
| Total Submitted Charge Amount | 581647 |
| Total Medicare Allowed Amount | 349950.65 |
| Total Medicare Payment Amount | 255076.71 |
| Total Medicare Standardized Payment Amount | 256977.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 648 |
| Number Of Medicare Beneficiaries With Drug Services | 378 |
| Total Drug Submitted ChargeAmount | 19507 |
| Total Drug Medicare AllowedAmount | 15439.48 |
| Total Drug Medicare PaymentAmount | 14724.46 |
| Total Drug Medicare Standardized Payment Amount | 14724.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 5190 |
| Number Of Medicare Beneficiaries With Medical Services | 1412 |
| Total Medical Submitted Charge Amount | 562140 |
| Total Medical Medicare Allowed Amount | 334511.17 |
| Total Medical Medicare Payment Amount | 240352.25 |
| Total Medical Medicare Standardized Payment Amount | 242252.59 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 151 |
| Number Of Beneficiaries Age 65 to 74 | 507 |
| Number Of Beneficiaries Age 75 to 84 | 444 |
| Number Of Beneficiaries Age Greater 84 | 310 |
| Number Of Female Beneficiaries | 816 |
| Number Of Male Beneficiaries | 596 |
| Number Of Non Hispanic White Beneficiaries | 1129 |
| Number Of Black or African American Beneficiaries | 167 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 244 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6913 |