| National Provider Identifier [NPI]: | 1144521329 |
| Last Name Of The Provider | LONDONO |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 219 NW 12TH AVE |
| Street Address 2 Of The Provider | C-5 |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331282205 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1063 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 274289 |
| Total Medicare Allowed Amount | 113734.44 |
| Total Medicare Payment Amount | 87949.62 |
| Total Medicare Standardized Payment Amount | 80906.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 247 |
| Total Drug Medicare AllowedAmount | 67.86 |
| Total Drug Medicare PaymentAmount | 57.96 |
| Total Drug Medicare Standardized Payment Amount | 57.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 999 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 274042 |
| Total Medical Medicare Allowed Amount | 113666.58 |
| Total Medical Medicare Payment Amount | 87891.66 |
| Total Medical Medicare Standardized Payment Amount | 80848.5 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | 50 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 130 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3428 |