| National Provider Identifier [NPI]: | 1144249012 |
| Last Name Of The Provider | VIRTUSIO |
| First Name Of The Provider | LOURDES |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2102 TOWN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | PENSACOLA |
| Zip Code Of The Provider | 32505 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 3186 |
| Number Of Medicare Beneficiaries | 630 |
| Total Submitted Charge Amount | 357115.45 |
| Total Medicare Allowed Amount | 260799.5 |
| Total Medicare Payment Amount | 180472.64 |
| Total Medicare Standardized Payment Amount | 185877.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 350 |
| Number Of Medicare Beneficiaries With Drug Services | 239 |
| Total Drug Submitted ChargeAmount | 6940.88 |
| Total Drug Medicare AllowedAmount | 1003.24 |
| Total Drug Medicare PaymentAmount | 667.55 |
| Total Drug Medicare Standardized Payment Amount | 667.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 2836 |
| Number Of Medicare Beneficiaries With Medical Services | 630 |
| Total Medical Submitted Charge Amount | 350174.57 |
| Total Medical Medicare Allowed Amount | 259796.26 |
| Total Medical Medicare Payment Amount | 179805.09 |
| Total Medical Medicare Standardized Payment Amount | 185209.96 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 246 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 198 |
| Number Of Non Hispanic White Beneficiaries | 370 |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | 66 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 500 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0796 |