| National Provider Identifier [NPI]: | 1578653119 |
| Last Name Of The Provider | HASTILLO |
| First Name Of The Provider | ANDREA |
| 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 | 1250 E MARSHALL ST |
| Street Address 2 Of The Provider | INTERNAL MEDICINE |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232985051 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 2 |
| Number Of Services | 4861 |
| Number Of Medicare Beneficiaries | 3162 |
| Total Submitted Charge Amount | 160413 |
| Total Medicare Allowed Amount | 41172.67 |
| Total Medicare Payment Amount | 30812.75 |
| Total Medicare Standardized Payment Amount | 32118.25 |
| 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 | 2 |
| Number Of Medical Services | 4861 |
| Number Of Medicare Beneficiaries With Medical Services | 3162 |
| Total Medical Submitted Charge Amount | 160413 |
| Total Medical Medicare Allowed Amount | 41172.67 |
| Total Medical Medicare Payment Amount | 30812.75 |
| Total Medical Medicare Standardized Payment Amount | 32118.25 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 1026 |
| Number Of Beneficiaries Age 65 to 74 | 1223 |
| Number Of Beneficiaries Age 75 to 84 | 682 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 1592 |
| Number Of Male Beneficiaries | 1570 |
| Number Of Non Hispanic White Beneficiaries | 1633 |
| Number Of Black or African American Beneficiaries | 1419 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2035 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1127 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.4706 |