| National Provider Identifier [NPI]: | 1649266925 |
| Last Name Of The Provider | ALFONSO |
| First Name Of The Provider | JESUS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7907 KENNEDY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH BERGEN |
| Zip Code Of The Provider | 070474137 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 973 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 258448 |
| Total Medicare Allowed Amount | 86906.29 |
| Total Medicare Payment Amount | 63604.12 |
| Total Medicare Standardized Payment Amount | 57408.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 86 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 5012 |
| Total Drug Medicare AllowedAmount | 1821.8 |
| Total Drug Medicare PaymentAmount | 1785.19 |
| Total Drug Medicare Standardized Payment Amount | 1785.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 887 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 253436 |
| Total Medical Medicare Allowed Amount | 85084.49 |
| Total Medical Medicare Payment Amount | 61818.93 |
| Total Medical Medicare Standardized Payment Amount | 55623.17 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 119 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 157 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 81 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1329 |