| National Provider Identifier [NPI]: | 1720045842 |
| Last Name Of The Provider | LEDESMA |
| First Name Of The Provider | GILBERT |
| 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 | 707 N FIELDER RD |
| Street Address 2 Of The Provider | #A |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 76012 |
| 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 | 29 |
| Number Of Services | 2544 |
| Number Of Medicare Beneficiaries | 333 |
| Total Submitted Charge Amount | 111688.21 |
| Total Medicare Allowed Amount | 69561.59 |
| Total Medicare Payment Amount | 48666.95 |
| Total Medicare Standardized Payment Amount | 49380.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1392 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 11448 |
| Total Drug Medicare AllowedAmount | 3340.17 |
| Total Drug Medicare PaymentAmount | 3158.94 |
| Total Drug Medicare Standardized Payment Amount | 3158.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 1152 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 100240.21 |
| Total Medical Medicare Allowed Amount | 66221.42 |
| Total Medical Medicare Payment Amount | 45508.01 |
| Total Medical Medicare Standardized Payment Amount | 46221.17 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 189 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 290 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8597 |