| National Provider Identifier [NPI]: | 1770562936 |
| Last Name Of The Provider | FABER |
| First Name Of The Provider | JOANA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6201 N SUNCOAST BLVD |
| Street Address 2 Of The Provider | SEVEN RIVERS MED CENTER - PATHOLOGY DEPT |
| City Of The Provider | CRYSTAL RIVER |
| Zip Code Of The Provider | 344286712 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 6064 |
| Number Of Medicare Beneficiaries | 1806 |
| Total Submitted Charge Amount | 890191.81 |
| Total Medicare Allowed Amount | 175800.21 |
| Total Medicare Payment Amount | 136725.98 |
| Total Medicare Standardized Payment Amount | 112454.59 |
| 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 | 22 |
| Number Of Medical Services | 6064 |
| Number Of Medicare Beneficiaries With Medical Services | 1806 |
| Total Medical Submitted Charge Amount | 890191.81 |
| Total Medical Medicare Allowed Amount | 175800.21 |
| Total Medical Medicare Payment Amount | 136725.98 |
| Total Medical Medicare Standardized Payment Amount | 112454.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 761 |
| Number Of Beneficiaries Age 75 to 84 | 636 |
| Number Of Beneficiaries Age Greater 84 | 225 |
| Number Of Female Beneficiaries | 971 |
| Number Of Male Beneficiaries | 835 |
| Number Of Non Hispanic White Beneficiaries | 1693 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 282 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4865 |