| National Provider Identifier [NPI]: | 1053344499 |
| Last Name Of The Provider | VILLEGAS |
| First Name Of The Provider | LYDIA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5050 NE HOYT ST |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972132991 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 198 |
| Number Of Medicare Beneficiaries | 45 |
| Total Submitted Charge Amount | 43111 |
| Total Medicare Allowed Amount | 14145.12 |
| Total Medicare Payment Amount | 9676.11 |
| Total Medicare Standardized Payment Amount | 9710.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 749 |
| Total Drug Medicare AllowedAmount | 477.89 |
| Total Drug Medicare PaymentAmount | 467.73 |
| Total Drug Medicare Standardized Payment Amount | 467.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 181 |
| Number Of Medicare Beneficiaries With Medical Services | 45 |
| Total Medical Submitted Charge Amount | 42362 |
| Total Medical Medicare Allowed Amount | 13667.23 |
| Total Medical Medicare Payment Amount | 9208.38 |
| Total Medical Medicare Standardized Payment Amount | 9242.47 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | 11 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 32 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| 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 | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1149 |