| National Provider Identifier [NPI]: | 1750311726 |
| Last Name Of The Provider | BENAVIDES |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 341 WHEATFIELD DR |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | SUNNYVALE |
| Zip Code Of The Provider | 751824638 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 4456 |
| Number Of Medicare Beneficiaries | 749 |
| Total Submitted Charge Amount | 811308.12 |
| Total Medicare Allowed Amount | 389877.36 |
| Total Medicare Payment Amount | 290037.68 |
| Total Medicare Standardized Payment Amount | 293071.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1070 |
| Number Of Medicare Beneficiaries With Drug Services | 156 |
| Total Drug Submitted ChargeAmount | 20770.62 |
| Total Drug Medicare AllowedAmount | 8926.47 |
| Total Drug Medicare PaymentAmount | 6832.13 |
| Total Drug Medicare Standardized Payment Amount | 6832.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3386 |
| Number Of Medicare Beneficiaries With Medical Services | 749 |
| Total Medical Submitted Charge Amount | 790537.5 |
| Total Medical Medicare Allowed Amount | 380950.89 |
| Total Medical Medicare Payment Amount | 283205.55 |
| Total Medical Medicare Standardized Payment Amount | 286239.08 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 392 |
| Number Of Beneficiaries Age 65 to 74 | 221 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 494 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 581 |
| Number Of Black or African American Beneficiaries | 131 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5678 |