| National Provider Identifier [NPI]: | 1548231905 |
| Last Name Of The Provider | GONZABA |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 720 PLEASANTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782141306 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 8000 |
| Number Of Medicare Beneficiaries | 899 |
| Total Submitted Charge Amount | 793792.34 |
| Total Medicare Allowed Amount | 318636.13 |
| Total Medicare Payment Amount | 227315.68 |
| Total Medicare Standardized Payment Amount | 243856.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 27 |
| Number Of Drug Services | 2477 |
| Number Of Medicare Beneficiaries With Drug Services | 389 |
| Total Drug Submitted ChargeAmount | 8271.58 |
| Total Drug Medicare AllowedAmount | 3272.19 |
| Total Drug Medicare PaymentAmount | 2776.06 |
| Total Drug Medicare Standardized Payment Amount | 2776.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 5523 |
| Number Of Medicare Beneficiaries With Medical Services | 899 |
| Total Medical Submitted Charge Amount | 785520.76 |
| Total Medical Medicare Allowed Amount | 315363.94 |
| Total Medical Medicare Payment Amount | 224539.62 |
| Total Medical Medicare Standardized Payment Amount | 241080.59 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 424 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 544 |
| Number Of Male Beneficiaries | 355 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 711 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 278 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6361 |