| National Provider Identifier [NPI]: | 1144255217 |
| Last Name Of The Provider | GIN |
| First Name Of The Provider | GENEEN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9909 MIRA MESA BLVD |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921311056 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 442 |
| Number Of Medicare Beneficiaries | 225 |
| Total Submitted Charge Amount | 67158 |
| Total Medicare Allowed Amount | 29664.51 |
| Total Medicare Payment Amount | 20990.98 |
| Total Medicare Standardized Payment Amount | 20474.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1407 |
| Total Drug Medicare AllowedAmount | 792.43 |
| Total Drug Medicare PaymentAmount | 775.4 |
| Total Drug Medicare Standardized Payment Amount | 775.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 416 |
| Number Of Medicare Beneficiaries With Medical Services | 225 |
| Total Medical Submitted Charge Amount | 65751 |
| Total Medical Medicare Allowed Amount | 28872.08 |
| Total Medical Medicare Payment Amount | 20215.58 |
| Total Medical Medicare Standardized Payment Amount | 19699.05 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 87 |
| Number Of Non Hispanic White Beneficiaries | 122 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 140 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5874 |