| National Provider Identifier [NPI]: | 1558335471 |
| Last Name Of The Provider | WAREHAM |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 850 E LATHAM AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | HEMET |
| Zip Code Of The Provider | 925434391 |
| 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 | 119 |
| Number Of Services | 5526 |
| Number Of Medicare Beneficiaries | 1457 |
| Total Submitted Charge Amount | 621255.62 |
| Total Medicare Allowed Amount | 274407.62 |
| Total Medicare Payment Amount | 224759.21 |
| Total Medicare Standardized Payment Amount | 211385.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2861 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 2263.62 |
| Total Drug Medicare AllowedAmount | 1215.66 |
| Total Drug Medicare PaymentAmount | 882.35 |
| Total Drug Medicare Standardized Payment Amount | 882.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 2665 |
| Number Of Medicare Beneficiaries With Medical Services | 1457 |
| Total Medical Submitted Charge Amount | 618992 |
| Total Medical Medicare Allowed Amount | 273191.96 |
| Total Medical Medicare Payment Amount | 223876.86 |
| Total Medical Medicare Standardized Payment Amount | 210503.45 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 233 |
| Number Of Beneficiaries Age 65 to 74 | 657 |
| Number Of Beneficiaries Age 75 to 84 | 401 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 1125 |
| Number Of Male Beneficiaries | 332 |
| Number Of Non Hispanic White Beneficiaries | 1052 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 270 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1019 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 438 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2423 |