| National Provider Identifier [NPI]: | 1720209901 |
| Last Name Of The Provider | SIFUENTES |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13701 NORTHWEST BLVD |
| Street Address 2 Of The Provider | STE #A |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784105114 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1552 |
| Number Of Medicare Beneficiaries | 295 |
| Total Submitted Charge Amount | 98631.32 |
| Total Medicare Allowed Amount | 93493.82 |
| Total Medicare Payment Amount | 60465.12 |
| Total Medicare Standardized Payment Amount | 65126.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 890 |
| Total Drug Medicare AllowedAmount | 24.77 |
| Total Drug Medicare PaymentAmount | 14.73 |
| Total Drug Medicare Standardized Payment Amount | 14.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 1486 |
| Number Of Medicare Beneficiaries With Medical Services | 295 |
| Total Medical Submitted Charge Amount | 97741.32 |
| Total Medical Medicare Allowed Amount | 93469.05 |
| Total Medical Medicare Payment Amount | 60450.39 |
| Total Medical Medicare Standardized Payment Amount | 65111.51 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 183 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 173 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 122 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7369 |