| National Provider Identifier [NPI]: | 1164766648 |
| Last Name Of The Provider | MACIDO |
| First Name Of The Provider | ANTONY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MSN, ACNP-BC, CNS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4955 VAN NUYS BLVD |
| Street Address 2 Of The Provider | SUITE 502 |
| City Of The Provider | SHERMAN OAKS |
| Zip Code Of The Provider | 914031801 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 932 |
| Number Of Medicare Beneficiaries | 232 |
| Total Submitted Charge Amount | 129365 |
| Total Medicare Allowed Amount | 83585.18 |
| Total Medicare Payment Amount | 64782.35 |
| Total Medicare Standardized Payment Amount | 71685.86 |
| 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 | 8 |
| Number Of Medical Services | 932 |
| Number Of Medicare Beneficiaries With Medical Services | 232 |
| Total Medical Submitted Charge Amount | 129365 |
| Total Medical Medicare Allowed Amount | 83585.18 |
| Total Medical Medicare Payment Amount | 64782.35 |
| Total Medical Medicare Standardized Payment Amount | 71685.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 129 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 41 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 49 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 183 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 47 |
| Percent Of With Asthma | 28 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 75 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 72 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 26 |
| Average HCC Risk Score Of Beneficiaries | 4.2524 |