| National Provider Identifier [NPI]: | 1093914681 |
| Last Name Of The Provider | AYALA |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14615 SAN PEDRO AVE |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782324321 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 44111 |
| Number Of Medicare Beneficiaries | 282 |
| Total Submitted Charge Amount | 1379224.7 |
| Total Medicare Allowed Amount | 620249.54 |
| Total Medicare Payment Amount | 477394.08 |
| Total Medicare Standardized Payment Amount | 488582.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 42236 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 1026566.4 |
| Total Drug Medicare AllowedAmount | 475546.88 |
| Total Drug Medicare PaymentAmount | 372180.01 |
| Total Drug Medicare Standardized Payment Amount | 372180.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1875 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 352658.3 |
| Total Medical Medicare Allowed Amount | 144702.66 |
| Total Medical Medicare Payment Amount | 105214.07 |
| Total Medical Medicare Standardized Payment Amount | 116402.7 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 223 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 164 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 103 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2817 |