| National Provider Identifier [NPI]: | 1437315769 |
| Last Name Of The Provider | CORTEZ |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 PARK CREEK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLOVIS |
| Zip Code Of The Provider | 936114426 |
| 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 | 38 |
| Number Of Services | 3113 |
| Number Of Medicare Beneficiaries | 1211 |
| Total Submitted Charge Amount | 417746 |
| Total Medicare Allowed Amount | 167227.23 |
| Total Medicare Payment Amount | 129637.5 |
| Total Medicare Standardized Payment Amount | 94068.74 |
| 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 | 38 |
| Number Of Medical Services | 3113 |
| Number Of Medicare Beneficiaries With Medical Services | 1211 |
| Total Medical Submitted Charge Amount | 417746 |
| Total Medical Medicare Allowed Amount | 167227.23 |
| Total Medical Medicare Payment Amount | 129637.5 |
| Total Medical Medicare Standardized Payment Amount | 94068.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 202 |
| Number Of Beneficiaries Age 65 to 74 | 561 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 652 |
| Number Of Male Beneficiaries | 559 |
| Number Of Non Hispanic White Beneficiaries | 754 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 74 |
| Number Of Hispanic Beneficiaries | 308 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 790 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 421 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4373 |