| National Provider Identifier [NPI]: | 1376601690 |
| Last Name Of The Provider | VILLANUEVA |
| First Name Of The Provider | BENEDICT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5401 NORRIS CANYON RD |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | SAN RAMON |
| Zip Code Of The Provider | 945835409 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 1111 |
| Number Of Medicare Beneficiaries | 246 |
| Total Submitted Charge Amount | 210000 |
| Total Medicare Allowed Amount | 123658.19 |
| Total Medicare Payment Amount | 96897.65 |
| Total Medicare Standardized Payment Amount | 90657.96 |
| 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 | 9 |
| Number Of Medical Services | 1111 |
| Number Of Medicare Beneficiaries With Medical Services | 246 |
| Total Medical Submitted Charge Amount | 210000 |
| Total Medical Medicare Allowed Amount | 123658.19 |
| Total Medical Medicare Payment Amount | 96897.65 |
| Total Medical Medicare Standardized Payment Amount | 90657.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 173 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 179 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.4984 |