| National Provider Identifier [NPI]: | 1407870652 |
| Last Name Of The Provider | ALLAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 58 WEST LOOP DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMARILLO |
| Zip Code Of The Provider | 93010 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 6238 |
| Number Of Medicare Beneficiaries | 1166 |
| Total Submitted Charge Amount | 803851.92 |
| Total Medicare Allowed Amount | 637484.51 |
| Total Medicare Payment Amount | 480749.71 |
| Total Medicare Standardized Payment Amount | 448511.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 760 |
| Number Of Medicare Beneficiaries With Drug Services | 491 |
| Total Drug Submitted ChargeAmount | 11816.5 |
| Total Drug Medicare AllowedAmount | 7748.49 |
| Total Drug Medicare PaymentAmount | 7489.17 |
| Total Drug Medicare Standardized Payment Amount | 7489.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 5478 |
| Number Of Medicare Beneficiaries With Medical Services | 1166 |
| Total Medical Submitted Charge Amount | 792035.42 |
| Total Medical Medicare Allowed Amount | 629736.02 |
| Total Medical Medicare Payment Amount | 473260.54 |
| Total Medical Medicare Standardized Payment Amount | 441022.44 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 428 |
| Number Of Beneficiaries Age Greater 84 | 442 |
| Number Of Female Beneficiaries | 684 |
| Number Of Male Beneficiaries | 482 |
| Number Of Non Hispanic White Beneficiaries | 982 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 119 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 963 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5609 |