| National Provider Identifier [NPI]: | 1871571455 |
| Last Name Of The Provider | GUZMAN |
| First Name Of The Provider | MADONNA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | P.A.-C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10666 N TORREY PINES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920371027 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2153 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 172272.74 |
| Total Medicare Allowed Amount | 59395.13 |
| Total Medicare Payment Amount | 44929.46 |
| Total Medicare Standardized Payment Amount | 48227.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1573 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 51645 |
| Total Drug Medicare AllowedAmount | 19733.87 |
| Total Drug Medicare PaymentAmount | 15468.63 |
| Total Drug Medicare Standardized Payment Amount | 15468.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 580 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 120627.74 |
| Total Medical Medicare Allowed Amount | 39661.26 |
| Total Medical Medicare Payment Amount | 29460.83 |
| Total Medical Medicare Standardized Payment Amount | 32759.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 172 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0955 |