| National Provider Identifier [NPI]: | 1184612384 |
| Last Name Of The Provider | BOTROS |
| First Name Of The Provider | SAMIA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 340 DARDANELLI LN |
| Street Address 2 Of The Provider | STE 15A |
| City Of The Provider | LOS GATOS |
| Zip Code Of The Provider | 950321418 |
| 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 | 33 |
| Number Of Services | 1547 |
| Number Of Medicare Beneficiaries | 336 |
| Total Submitted Charge Amount | 185818.06 |
| Total Medicare Allowed Amount | 150199.52 |
| Total Medicare Payment Amount | 113443.12 |
| Total Medicare Standardized Payment Amount | 96288.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 1857 |
| Total Drug Medicare AllowedAmount | 1779.04 |
| Total Drug Medicare PaymentAmount | 1743.05 |
| Total Drug Medicare Standardized Payment Amount | 1743.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1430 |
| Number Of Medicare Beneficiaries With Medical Services | 336 |
| Total Medical Submitted Charge Amount | 183961.06 |
| Total Medical Medicare Allowed Amount | 148420.48 |
| Total Medical Medicare Payment Amount | 111700.07 |
| Total Medical Medicare Standardized Payment Amount | 94545.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 273 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.7674 |