| National Provider Identifier [NPI]: | 1013127877 |
| Last Name Of The Provider | BUSTAMANTE |
| First Name Of The Provider | ANGEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 941 S ATLANTIC BLVD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MONTEREY PARK |
| Zip Code Of The Provider | 917544722 |
| 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 | 82 |
| Number Of Services | 13390 |
| Number Of Medicare Beneficiaries | 440 |
| Total Submitted Charge Amount | 2158769.78 |
| Total Medicare Allowed Amount | 488832.34 |
| Total Medicare Payment Amount | 368759.7 |
| Total Medicare Standardized Payment Amount | 388043.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 6203 |
| Number Of Medicare Beneficiaries With Drug Services | 355 |
| Total Drug Submitted ChargeAmount | 259387.5 |
| Total Drug Medicare AllowedAmount | 62530.32 |
| Total Drug Medicare PaymentAmount | 48767.93 |
| Total Drug Medicare Standardized Payment Amount | 48767.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 7187 |
| Number Of Medicare Beneficiaries With Medical Services | 440 |
| Total Medical Submitted Charge Amount | 1899382.28 |
| Total Medical Medicare Allowed Amount | 426302.02 |
| Total Medical Medicare Payment Amount | 319991.77 |
| Total Medical Medicare Standardized Payment Amount | 339275.89 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 124 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 349 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 13 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 413 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 411 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 72 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 39 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3663 |