| National Provider Identifier [NPI]: | 1104827906 |
| Last Name Of The Provider | ALLISON |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 415 E HARDING WAY |
| Street Address 2 Of The Provider | #H |
| City Of The Provider | STOCKTON |
| Zip Code Of The Provider | 952046118 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 700 |
| Number Of Medicare Beneficiaries | 110 |
| Total Submitted Charge Amount | 109495 |
| Total Medicare Allowed Amount | 68133.69 |
| Total Medicare Payment Amount | 51302.34 |
| Total Medicare Standardized Payment Amount | 53892.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 62 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 32900 |
| Total Drug Medicare AllowedAmount | 12062.28 |
| Total Drug Medicare PaymentAmount | 9121.53 |
| Total Drug Medicare Standardized Payment Amount | 9121.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 638 |
| Number Of Medicare Beneficiaries With Medical Services | 110 |
| Total Medical Submitted Charge Amount | 76595 |
| Total Medical Medicare Allowed Amount | 56071.41 |
| Total Medical Medicare Payment Amount | 42180.81 |
| Total Medical Medicare Standardized Payment Amount | 44771 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 34 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 58 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 42 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3878 |