| National Provider Identifier [NPI]: | 1144309147 |
| Last Name Of The Provider | VILLA |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 ESSEX ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HACKENSACK |
| Zip Code Of The Provider | 076013231 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 4776 |
| Number Of Medicare Beneficiaries | 1049 |
| Total Submitted Charge Amount | 838328.35 |
| Total Medicare Allowed Amount | 453209.81 |
| Total Medicare Payment Amount | 349207.7 |
| Total Medicare Standardized Payment Amount | 325556.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 2204.62 |
| Total Drug Medicare AllowedAmount | 1330.42 |
| Total Drug Medicare PaymentAmount | 1276.05 |
| Total Drug Medicare Standardized Payment Amount | 1276.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 4713 |
| Number Of Medicare Beneficiaries With Medical Services | 1049 |
| Total Medical Submitted Charge Amount | 836123.73 |
| Total Medical Medicare Allowed Amount | 451879.39 |
| Total Medical Medicare Payment Amount | 347931.65 |
| Total Medical Medicare Standardized Payment Amount | 324280.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 397 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 198 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 531 |
| Number Of Non Hispanic White Beneficiaries | 896 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 942 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.2073 |