| National Provider Identifier [NPI]: | 1245288109 |
| Last Name Of The Provider | URQUIDI |
| First Name Of The Provider | ULYSSES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 DENVER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EL PASO |
| Zip Code Of The Provider | 799023008 |
| 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 | 42 |
| Number Of Services | 1314 |
| Number Of Medicare Beneficiaries | 253 |
| Total Submitted Charge Amount | 159063.01 |
| Total Medicare Allowed Amount | 90137.58 |
| Total Medicare Payment Amount | 63193.06 |
| Total Medicare Standardized Payment Amount | 65866.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 227 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 6851.01 |
| Total Drug Medicare AllowedAmount | 1111.07 |
| Total Drug Medicare PaymentAmount | 1006.59 |
| Total Drug Medicare Standardized Payment Amount | 1006.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1087 |
| Number Of Medicare Beneficiaries With Medical Services | 253 |
| Total Medical Submitted Charge Amount | 152212 |
| Total Medical Medicare Allowed Amount | 89026.51 |
| Total Medical Medicare Payment Amount | 62186.47 |
| Total Medical Medicare Standardized Payment Amount | 64860.28 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | 66 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 171 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 42 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4579 |