| National Provider Identifier [NPI]: | 1174611750 |
| Last Name Of The Provider | ZEVALLOS |
| First Name Of The Provider | MANUEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3737 MARTIN LUTHER KING JR BLVD |
| Street Address 2 Of The Provider | SUITE 335 |
| City Of The Provider | LYNWOOD |
| Zip Code Of The Provider | 902623513 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 8019 |
| Number Of Medicare Beneficiaries | 394 |
| Total Submitted Charge Amount | 526128.8 |
| Total Medicare Allowed Amount | 279099.87 |
| Total Medicare Payment Amount | 209178.83 |
| Total Medicare Standardized Payment Amount | 195161.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 29 |
| Number Of Drug Services | 5348 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 78745.8 |
| Total Drug Medicare AllowedAmount | 46827.17 |
| Total Drug Medicare PaymentAmount | 36834.74 |
| Total Drug Medicare Standardized Payment Amount | 36834.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2671 |
| Number Of Medicare Beneficiaries With Medical Services | 394 |
| Total Medical Submitted Charge Amount | 447383 |
| Total Medical Medicare Allowed Amount | 232272.7 |
| Total Medical Medicare Payment Amount | 172344.09 |
| Total Medical Medicare Standardized Payment Amount | 158327.16 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 141 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 244 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 79 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 294 |
| 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 | 345 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.3666 |