| National Provider Identifier [NPI]: | 1790984730 |
| Last Name Of The Provider | RICO |
| First Name Of The Provider | WILFRED |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7000 SUNNE LANE |
| Street Address 2 Of The Provider | APT. 601 |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 94597 |
| 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 | 16 |
| Number Of Services | 598 |
| Number Of Medicare Beneficiaries | 386 |
| Total Submitted Charge Amount | 230862 |
| Total Medicare Allowed Amount | 67966.51 |
| Total Medicare Payment Amount | 52231.24 |
| Total Medicare Standardized Payment Amount | 51273.61 |
| 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 | 16 |
| Number Of Medical Services | 598 |
| Number Of Medicare Beneficiaries With Medical Services | 386 |
| Total Medical Submitted Charge Amount | 230862 |
| Total Medical Medicare Allowed Amount | 67966.51 |
| Total Medical Medicare Payment Amount | 52231.24 |
| Total Medical Medicare Standardized Payment Amount | 51273.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 186 |
| Number Of Non Hispanic White Beneficiaries | 229 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 95 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 150 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 236 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3625 |