| National Provider Identifier [NPI]: | 1316045636 |
| Last Name Of The Provider | DESILVA |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 29809 SANTA MARGARITA PKWY |
| Street Address 2 Of The Provider | SUITE#300 |
| City Of The Provider | RANCHO SANTA MARGARITA |
| Zip Code Of The Provider | 926883613 |
| 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 | 694 |
| Number Of Medicare Beneficiaries | 98 |
| Total Submitted Charge Amount | 65123 |
| Total Medicare Allowed Amount | 52696.25 |
| Total Medicare Payment Amount | 41139.35 |
| Total Medicare Standardized Payment Amount | 36887.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 152 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 5880 |
| Total Drug Medicare AllowedAmount | 3273.34 |
| Total Drug Medicare PaymentAmount | 3025.44 |
| Total Drug Medicare Standardized Payment Amount | 3025.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 542 |
| Number Of Medicare Beneficiaries With Medical Services | 93 |
| Total Medical Submitted Charge Amount | 59243 |
| Total Medical Medicare Allowed Amount | 49422.91 |
| Total Medical Medicare Payment Amount | 38113.91 |
| Total Medical Medicare Standardized Payment Amount | 33861.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 48 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 73 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9427 |