| National Provider Identifier [NPI]: | 1891781993 |
| Last Name Of The Provider | VILLANUEVA |
| First Name Of The Provider | JUANITO |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 411 30TH ST |
| Street Address 2 Of The Provider | #508 |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 946093310 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 3136 |
| Number Of Medicare Beneficiaries | 2225 |
| Total Submitted Charge Amount | 480931.8 |
| Total Medicare Allowed Amount | 125901.13 |
| Total Medicare Payment Amount | 91575.03 |
| Total Medicare Standardized Payment Amount | 88700.59 |
| 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 | 185 |
| Number Of Medical Services | 3136 |
| Number Of Medicare Beneficiaries With Medical Services | 2225 |
| Total Medical Submitted Charge Amount | 480931.8 |
| Total Medical Medicare Allowed Amount | 125901.13 |
| Total Medical Medicare Payment Amount | 91575.03 |
| Total Medical Medicare Standardized Payment Amount | 88700.59 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 408 |
| Number Of Beneficiaries Age 65 to 74 | 823 |
| Number Of Beneficiaries Age 75 to 84 | 629 |
| Number Of Beneficiaries Age Greater 84 | 365 |
| Number Of Female Beneficiaries | 1328 |
| Number Of Male Beneficiaries | 897 |
| Number Of Non Hispanic White Beneficiaries | 1491 |
| Number Of Black or African American Beneficiaries | 240 |
| Number Of AsianPacific Islander Beneficiaries | 108 |
| Number Of Hispanic Beneficiaries | 293 |
| Number Of American Indian Alaska Native Beneficiaries | 69 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1372 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 853 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8832 |