| National Provider Identifier [NPI]: | 1447396015 |
| Last Name Of The Provider | VALLEJO-MANZUR |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 E SAVANNAH AVE |
| Street Address 2 Of The Provider | SUITE 16 |
| City Of The Provider | MCALLEN |
| Zip Code Of The Provider | 785031727 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 6046 |
| Number Of Medicare Beneficiaries | 1085 |
| Total Submitted Charge Amount | 930275.08 |
| Total Medicare Allowed Amount | 538822.2 |
| Total Medicare Payment Amount | 414246.74 |
| Total Medicare Standardized Payment Amount | 425275.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 835 |
| Total Drug Medicare AllowedAmount | 269.39 |
| Total Drug Medicare PaymentAmount | 262.72 |
| Total Drug Medicare Standardized Payment Amount | 262.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 5981 |
| Number Of Medicare Beneficiaries With Medical Services | 1085 |
| Total Medical Submitted Charge Amount | 929440.08 |
| Total Medical Medicare Allowed Amount | 538552.81 |
| Total Medical Medicare Payment Amount | 413984.02 |
| Total Medical Medicare Standardized Payment Amount | 425012.81 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 366 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 544 |
| Number Of Male Beneficiaries | 541 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 836 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 360 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 725 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 70 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 3.2682 |