| National Provider Identifier [NPI]: | 1750384129 |
| Last Name Of The Provider | CARL |
| First Name Of The Provider | DAVID |
| 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 | 9400 N NAME UNO |
| Street Address 2 Of The Provider | |
| City Of The Provider | GILROY |
| Zip Code Of The Provider | 950203528 |
| 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 | 21 |
| Number Of Services | 1709 |
| Number Of Medicare Beneficiaries | 871 |
| Total Submitted Charge Amount | 278555 |
| Total Medicare Allowed Amount | 76775.51 |
| Total Medicare Payment Amount | 59813.67 |
| Total Medicare Standardized Payment Amount | 40846.21 |
| 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 | 21 |
| Number Of Medical Services | 1709 |
| Number Of Medicare Beneficiaries With Medical Services | 871 |
| Total Medical Submitted Charge Amount | 278555 |
| Total Medical Medicare Allowed Amount | 76775.51 |
| Total Medical Medicare Payment Amount | 59813.67 |
| Total Medical Medicare Standardized Payment Amount | 40846.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 396 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 488 |
| Number Of Male Beneficiaries | 383 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 285 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 633 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2498 |