| National Provider Identifier [NPI]: | 1598736126 |
| Last Name Of The Provider | AMBROSIA |
| First Name Of The Provider | ALPHONSE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6116 E ARBOR AVE |
| Street Address 2 Of The Provider | SUITE 112 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852066107 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 6333 |
| Number Of Medicare Beneficiaries | 1063 |
| Total Submitted Charge Amount | 1340343 |
| Total Medicare Allowed Amount | 657363.01 |
| Total Medicare Payment Amount | 491037.53 |
| Total Medicare Standardized Payment Amount | 499395.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 523 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 53154 |
| Total Drug Medicare AllowedAmount | 26692.93 |
| Total Drug Medicare PaymentAmount | 20497.3 |
| Total Drug Medicare Standardized Payment Amount | 20497.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 5810 |
| Number Of Medicare Beneficiaries With Medical Services | 1063 |
| Total Medical Submitted Charge Amount | 1287189 |
| Total Medical Medicare Allowed Amount | 630670.08 |
| Total Medical Medicare Payment Amount | 470540.23 |
| Total Medical Medicare Standardized Payment Amount | 478898.22 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 455 |
| Number Of Beneficiaries Age 75 to 84 | 383 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 541 |
| Number Of Male Beneficiaries | 522 |
| Number Of Non Hispanic White Beneficiaries | 976 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1007 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5202 |