| National Provider Identifier [NPI]: | 1922119445 |
| Last Name Of The Provider | BEDOYA |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 340 4TH AVE |
| Street Address 2 Of The Provider | STE 4 |
| City Of The Provider | CHULA VISTA |
| Zip Code Of The Provider | 919103813 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 6273 |
| Number Of Medicare Beneficiaries | 682 |
| Total Submitted Charge Amount | 895040.14 |
| Total Medicare Allowed Amount | 597205.97 |
| Total Medicare Payment Amount | 455434.42 |
| Total Medicare Standardized Payment Amount | 443603.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1790 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 50129 |
| Total Drug Medicare AllowedAmount | 22768.64 |
| Total Drug Medicare PaymentAmount | 18460.6 |
| Total Drug Medicare Standardized Payment Amount | 18460.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 4483 |
| Number Of Medicare Beneficiaries With Medical Services | 682 |
| Total Medical Submitted Charge Amount | 844911.14 |
| Total Medical Medicare Allowed Amount | 574437.33 |
| Total Medical Medicare Payment Amount | 436973.82 |
| Total Medical Medicare Standardized Payment Amount | 425142.61 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 376 |
| Number Of Male Beneficiaries | 306 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 450 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 495 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 4.7082 |