| National Provider Identifier [NPI]: | 1598762395 |
| Last Name Of The Provider | ALONZO |
| First Name Of The Provider | LESLIE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 403 VONDERBURG DR |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | BRANDON |
| Zip Code Of The Provider | 335115982 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 5839 |
| Number Of Medicare Beneficiaries | 822 |
| Total Submitted Charge Amount | 666817 |
| Total Medicare Allowed Amount | 327389.67 |
| Total Medicare Payment Amount | 246944.13 |
| Total Medicare Standardized Payment Amount | 252281.53 |
| 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 | 27 |
| Number Of Medical Services | 5839 |
| Number Of Medicare Beneficiaries With Medical Services | 822 |
| Total Medical Submitted Charge Amount | 666817 |
| Total Medical Medicare Allowed Amount | 327389.67 |
| Total Medical Medicare Payment Amount | 246944.13 |
| Total Medical Medicare Standardized Payment Amount | 252281.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 336 |
| Number Of Beneficiaries Age 75 to 84 | 316 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 511 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 640 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 726 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2073 |