| National Provider Identifier [NPI]: | 1528026846 |
| Last Name Of The Provider | DUARTE |
| First Name Of The Provider | LIONEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9302 E 22ND STREET |
| Street Address 2 Of The Provider | SAGUARO EASTSIDE MEDICAL GROUP |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 85710 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 5813 |
| Number Of Medicare Beneficiaries | 290 |
| Total Submitted Charge Amount | 335445.5 |
| Total Medicare Allowed Amount | 171467.89 |
| Total Medicare Payment Amount | 129383.41 |
| Total Medicare Standardized Payment Amount | 135240.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 2055 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 16042.5 |
| Total Drug Medicare AllowedAmount | 8834.62 |
| Total Drug Medicare PaymentAmount | 8493.4 |
| Total Drug Medicare Standardized Payment Amount | 8493.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 3758 |
| Number Of Medicare Beneficiaries With Medical Services | 290 |
| Total Medical Submitted Charge Amount | 319403 |
| Total Medical Medicare Allowed Amount | 162633.27 |
| Total Medical Medicare Payment Amount | 120890.01 |
| Total Medical Medicare Standardized Payment Amount | 126746.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 152 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 162 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 276 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8378 |