| National Provider Identifier [NPI]: | 1497723803 |
| Last Name Of The Provider | GERONIMO |
| First Name Of The Provider | REDEMPTION |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 790 EAST BONITA AVE |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | POMONA |
| Zip Code Of The Provider | 917671906 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 400 |
| Number Of Medicare Beneficiaries | 73 |
| Total Submitted Charge Amount | 56151.12 |
| Total Medicare Allowed Amount | 28247.94 |
| Total Medicare Payment Amount | 21231.87 |
| Total Medicare Standardized Payment Amount | 19648.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1046.12 |
| Total Drug Medicare AllowedAmount | 541.67 |
| Total Drug Medicare PaymentAmount | 526.68 |
| Total Drug Medicare Standardized Payment Amount | 526.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 349 |
| Number Of Medicare Beneficiaries With Medical Services | 73 |
| Total Medical Submitted Charge Amount | 55105 |
| Total Medical Medicare Allowed Amount | 27706.27 |
| Total Medical Medicare Payment Amount | 20705.19 |
| Total Medical Medicare Standardized Payment Amount | 19121.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3727 |