| National Provider Identifier [NPI]: | 1326293895 |
| Last Name Of The Provider | QUINTANA |
| First Name Of The Provider | AMERICA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | P.A |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10769 CHAMPAGNE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALTA LOMA |
| Zip Code Of The Provider | 917376971 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 118 |
| Number Of Medicare Beneficiaries | 99 |
| Total Submitted Charge Amount | 113137.35 |
| Total Medicare Allowed Amount | 11508 |
| Total Medicare Payment Amount | 8309.26 |
| Total Medicare Standardized Payment Amount | 9697.24 |
| 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 | 19 |
| Number Of Medical Services | 118 |
| Number Of Medicare Beneficiaries With Medical Services | 99 |
| Total Medical Submitted Charge Amount | 113137.35 |
| Total Medical Medicare Allowed Amount | 11508 |
| Total Medical Medicare Payment Amount | 8309.26 |
| Total Medical Medicare Standardized Payment Amount | 9697.24 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 61 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | 42 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 33 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6644 |