| National Provider Identifier [NPI]: | 1124040787 |
| Last Name Of The Provider | ALONZO |
| First Name Of The Provider | JUDY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1783 EL CAMINO REAL |
| Street Address 2 Of The Provider | PATHOLOGY DEPT |
| City Of The Provider | BURLINGAME |
| Zip Code Of The Provider | 940103205 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2298 |
| Number Of Medicare Beneficiaries | 1124 |
| Total Submitted Charge Amount | 494206.96 |
| Total Medicare Allowed Amount | 142247.64 |
| Total Medicare Payment Amount | 109739.41 |
| Total Medicare Standardized Payment Amount | 79160.42 |
| 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 | 31 |
| Number Of Medical Services | 2298 |
| Number Of Medicare Beneficiaries With Medical Services | 1124 |
| Total Medical Submitted Charge Amount | 494206.96 |
| Total Medical Medicare Allowed Amount | 142247.64 |
| Total Medical Medicare Payment Amount | 109739.41 |
| Total Medical Medicare Standardized Payment Amount | 79160.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 542 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 642 |
| Number Of Male Beneficiaries | 482 |
| Number Of Non Hispanic White Beneficiaries | 797 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | 132 |
| Number Of Hispanic Beneficiaries | 82 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 971 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2042 |