| National Provider Identifier [NPI]: | 1740474733 |
| Last Name Of The Provider | ENRIQUEZ |
| First Name Of The Provider | ABILENE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 W CALIFORNIA BLVD |
| Street Address 2 Of The Provider | 2ND FL- VALENTINE BLDG |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911053010 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 608 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 199300 |
| Total Medicare Allowed Amount | 90547.05 |
| Total Medicare Payment Amount | 70830.47 |
| Total Medicare Standardized Payment Amount | 66908.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 608 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 199300 |
| Total Medical Medicare Allowed Amount | 90547.05 |
| Total Medical Medicare Payment Amount | 70830.47 |
| Total Medical Medicare Standardized Payment Amount | 66908.39 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 100 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 53 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 71 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 26 |
| Average HCC Risk Score Of Beneficiaries | 3.5677 |