| National Provider Identifier [NPI]: | 1104844398 |
| Last Name Of The Provider | VILLENA |
| First Name Of The Provider | TONY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 BEACH BLVD |
| Street Address 2 Of The Provider | CREDENTIALING DEPARTMENT |
| City Of The Provider | JACKSONVILLE BEACH |
| Zip Code Of The Provider | 322504368 |
| 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 | 98 |
| Number Of Services | 6281 |
| Number Of Medicare Beneficiaries | 848 |
| Total Submitted Charge Amount | 583658 |
| Total Medicare Allowed Amount | 331853.83 |
| Total Medicare Payment Amount | 238952.22 |
| Total Medicare Standardized Payment Amount | 241560.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1156 |
| Number Of Medicare Beneficiaries With Drug Services | 291 |
| Total Drug Submitted ChargeAmount | 27618 |
| Total Drug Medicare AllowedAmount | 10176.3 |
| Total Drug Medicare PaymentAmount | 8626.12 |
| Total Drug Medicare Standardized Payment Amount | 8626.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 5125 |
| Number Of Medicare Beneficiaries With Medical Services | 848 |
| Total Medical Submitted Charge Amount | 556040 |
| Total Medical Medicare Allowed Amount | 321677.53 |
| Total Medical Medicare Payment Amount | 230326.1 |
| Total Medical Medicare Standardized Payment Amount | 232934.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 392 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 544 |
| Number Of Male Beneficiaries | 304 |
| Number Of Non Hispanic White Beneficiaries | 733 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 748 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0974 |