| National Provider Identifier [NPI]: | 1659593606 |
| Last Name Of The Provider | VICTORIO |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2625 COFFEE RD |
| Street Address 2 Of The Provider | SUITE S |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953552050 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 7518 |
| Number Of Medicare Beneficiaries | 2318 |
| Total Submitted Charge Amount | 1092599.53 |
| Total Medicare Allowed Amount | 505662.98 |
| Total Medicare Payment Amount | 404955.08 |
| Total Medicare Standardized Payment Amount | 241412.95 |
| 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 | 43 |
| Number Of Medical Services | 7518 |
| Number Of Medicare Beneficiaries With Medical Services | 2318 |
| Total Medical Submitted Charge Amount | 1092599.53 |
| Total Medical Medicare Allowed Amount | 505662.98 |
| Total Medical Medicare Payment Amount | 404955.08 |
| Total Medical Medicare Standardized Payment Amount | 241412.95 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 541 |
| Number Of Beneficiaries Age 65 to 74 | 1250 |
| Number Of Beneficiaries Age 75 to 84 | 410 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 1760 |
| Number Of Male Beneficiaries | 558 |
| Number Of Non Hispanic White Beneficiaries | 1780 |
| Number Of Black or African American Beneficiaries | 133 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 253 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1772 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 546 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.942 |