| National Provider Identifier [NPI]: | 1831307883 |
| Last Name Of The Provider | ESCOBAR |
| First Name Of The Provider | SHAWNA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 34800 BOB WILSON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921341098 |
| 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 | 94 |
| Number Of Services | 6256 |
| Number Of Medicare Beneficiaries | 2035 |
| Total Submitted Charge Amount | 493538.51 |
| Total Medicare Allowed Amount | 123045.94 |
| Total Medicare Payment Amount | 93995.16 |
| Total Medicare Standardized Payment Amount | 90493.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2710 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 2740 |
| Total Drug Medicare AllowedAmount | 498.72 |
| Total Drug Medicare PaymentAmount | 390.99 |
| Total Drug Medicare Standardized Payment Amount | 390.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 3546 |
| Number Of Medicare Beneficiaries With Medical Services | 2035 |
| Total Medical Submitted Charge Amount | 490798.51 |
| Total Medical Medicare Allowed Amount | 122547.22 |
| Total Medical Medicare Payment Amount | 93604.17 |
| Total Medical Medicare Standardized Payment Amount | 90102.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 902 |
| Number Of Beneficiaries Age 75 to 84 | 601 |
| Number Of Beneficiaries Age Greater 84 | 267 |
| Number Of Female Beneficiaries | 1495 |
| Number Of Male Beneficiaries | 540 |
| Number Of Non Hispanic White Beneficiaries | 1417 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 109 |
| Number Of Hispanic Beneficiaries | 417 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 836 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3916 |