| National Provider Identifier [NPI]: | 1093879132 |
| Last Name Of The Provider | DEJO |
| First Name Of The Provider | JULIO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8998 FERN PARK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BURKE |
| Zip Code Of The Provider | 22015 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 873 |
| Number Of Medicare Beneficiaries | 136 |
| Total Submitted Charge Amount | 62245 |
| Total Medicare Allowed Amount | 53572.97 |
| Total Medicare Payment Amount | 35660.28 |
| Total Medicare Standardized Payment Amount | 33808.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 2155 |
| Total Drug Medicare AllowedAmount | 1317.41 |
| Total Drug Medicare PaymentAmount | 1290.92 |
| Total Drug Medicare Standardized Payment Amount | 1290.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 806 |
| Number Of Medicare Beneficiaries With Medical Services | 136 |
| Total Medical Submitted Charge Amount | 60090 |
| Total Medical Medicare Allowed Amount | 52255.56 |
| Total Medical Medicare Payment Amount | 34369.36 |
| Total Medical Medicare Standardized Payment Amount | 32517.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 19 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 67 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8978 |