| National Provider Identifier [NPI]: | 1669431953 |
| Last Name Of The Provider | VICTOR |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 BEVERLY BLVD |
| Street Address 2 Of The Provider | SOUTH TOWER, 5520 |
| City Of The Provider | WEST HOLLYWOOD |
| Zip Code Of The Provider | 900481804 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 2063 |
| Number Of Medicare Beneficiaries | 1454 |
| Total Submitted Charge Amount | 71386 |
| Total Medicare Allowed Amount | 24113.52 |
| Total Medicare Payment Amount | 17847.18 |
| Total Medicare Standardized Payment Amount | 16794.15 |
| 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 | 16 |
| Number Of Medical Services | 2063 |
| Number Of Medicare Beneficiaries With Medical Services | 1454 |
| Total Medical Submitted Charge Amount | 71386 |
| Total Medical Medicare Allowed Amount | 24113.52 |
| Total Medical Medicare Payment Amount | 17847.18 |
| Total Medical Medicare Standardized Payment Amount | 16794.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 202 |
| Number Of Beneficiaries Age 65 to 74 | 506 |
| Number Of Beneficiaries Age 75 to 84 | 426 |
| Number Of Beneficiaries Age Greater 84 | 320 |
| Number Of Female Beneficiaries | 671 |
| Number Of Male Beneficiaries | 783 |
| Number Of Non Hispanic White Beneficiaries | 988 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | 104 |
| Number Of Hispanic Beneficiaries | 135 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 893 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 561 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.7191 |