| National Provider Identifier [NPI]: | 1073703153 |
| Last Name Of The Provider | GARCIA |
| First Name Of The Provider | ALEJANDRO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1531 S MADISON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | APPLETON |
| Zip Code Of The Provider | 549151800 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 2111 |
| Number Of Medicare Beneficiaries | 143 |
| Total Submitted Charge Amount | 344735 |
| Total Medicare Allowed Amount | 79644.33 |
| Total Medicare Payment Amount | 60124.75 |
| Total Medicare Standardized Payment Amount | 62156.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1305 |
| Number Of Medicare Beneficiaries With Drug Services | 110 |
| Total Drug Submitted ChargeAmount | 38686 |
| Total Drug Medicare AllowedAmount | 13350.11 |
| Total Drug Medicare PaymentAmount | 10348.59 |
| Total Drug Medicare Standardized Payment Amount | 10348.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 806 |
| Number Of Medicare Beneficiaries With Medical Services | 143 |
| Total Medical Submitted Charge Amount | 306049 |
| Total Medical Medicare Allowed Amount | 66294.22 |
| Total Medical Medicare Payment Amount | 49776.16 |
| Total Medical Medicare Standardized Payment Amount | 51807.45 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 91 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9606 |