| National Provider Identifier [NPI]: | 1730188236 |
| Last Name Of The Provider | MICON |
| First Name Of The Provider | MONICA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | PUEBLO & BATH ST. |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA BARBARA |
| Zip Code Of The Provider | 931054390 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 14855 |
| Number Of Medicare Beneficiaries | 2007 |
| Total Submitted Charge Amount | 833986.56 |
| Total Medicare Allowed Amount | 276404.24 |
| Total Medicare Payment Amount | 213518.41 |
| Total Medicare Standardized Payment Amount | 203611.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 11795 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 13820 |
| Total Drug Medicare AllowedAmount | 2764.12 |
| Total Drug Medicare PaymentAmount | 2096.8 |
| Total Drug Medicare Standardized Payment Amount | 2096.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 3060 |
| Number Of Medicare Beneficiaries With Medical Services | 2007 |
| Total Medical Submitted Charge Amount | 820166.56 |
| Total Medical Medicare Allowed Amount | 273640.12 |
| Total Medical Medicare Payment Amount | 211421.61 |
| Total Medical Medicare Standardized Payment Amount | 201514.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 1017 |
| Number Of Beneficiaries Age 75 to 84 | 564 |
| Number Of Beneficiaries Age Greater 84 | 227 |
| Number Of Female Beneficiaries | 1262 |
| Number Of Male Beneficiaries | 745 |
| Number Of Non Hispanic White Beneficiaries | 1664 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 221 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1746 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0424 |