| National Provider Identifier [NPI]: | 1629013974 |
| Last Name Of The Provider | VILLARREAL |
| First Name Of The Provider | VICTOR |
| 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 | 3006 N RAUL LONGORIA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 785893676 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 4381 |
| Number Of Medicare Beneficiaries | 358 |
| Total Submitted Charge Amount | 252934 |
| Total Medicare Allowed Amount | 126541.88 |
| Total Medicare Payment Amount | 92936.99 |
| Total Medicare Standardized Payment Amount | 102598.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 185 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 8475 |
| Total Drug Medicare AllowedAmount | 2641.02 |
| Total Drug Medicare PaymentAmount | 2550.2 |
| Total Drug Medicare Standardized Payment Amount | 2550.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 4196 |
| Number Of Medicare Beneficiaries With Medical Services | 358 |
| Total Medical Submitted Charge Amount | 244459 |
| Total Medical Medicare Allowed Amount | 123900.86 |
| Total Medical Medicare Payment Amount | 90386.79 |
| Total Medical Medicare Standardized Payment Amount | 100047.86 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 327 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 111 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 247 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3063 |