| National Provider Identifier [NPI]: | 1497956981 |
| Last Name Of The Provider | AYALA |
| First Name Of The Provider | JUANBOSCO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10837 S CICERO AVE |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | OAK LAWN |
| Zip Code Of The Provider | 604536458 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 4644 |
| Number Of Medicare Beneficiaries | 930 |
| Total Submitted Charge Amount | 1510965 |
| Total Medicare Allowed Amount | 617714.9 |
| Total Medicare Payment Amount | 473797.31 |
| Total Medicare Standardized Payment Amount | 440460.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 4644 |
| Number Of Medicare Beneficiaries With Medical Services | 930 |
| Total Medical Submitted Charge Amount | 1510965 |
| Total Medical Medicare Allowed Amount | 617714.9 |
| Total Medical Medicare Payment Amount | 473797.31 |
| Total Medical Medicare Standardized Payment Amount | 440460.26 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 216 |
| Number Of Beneficiaries Age 65 to 74 | 318 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 134 |
| Number Of Female Beneficiaries | 511 |
| Number Of Male Beneficiaries | 419 |
| Number Of Non Hispanic White Beneficiaries | 216 |
| Number Of Black or African American Beneficiaries | 465 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 234 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 275 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 655 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 39 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 64 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 3.2977 |