| National Provider Identifier [NPI]: | 1528025749 |
| Last Name Of The Provider | BLAKE |
| First Name Of The Provider | MEGHAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3440 CALIFORNIA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941181837 |
| 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 | 93 |
| Number Of Services | 2977 |
| Number Of Medicare Beneficiaries | 1736 |
| Total Submitted Charge Amount | 2162851.35 |
| Total Medicare Allowed Amount | 480962.87 |
| Total Medicare Payment Amount | 368091.41 |
| Total Medicare Standardized Payment Amount | 322856.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 785 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 3855 |
| Total Drug Medicare AllowedAmount | 974.17 |
| Total Drug Medicare PaymentAmount | 694.23 |
| Total Drug Medicare Standardized Payment Amount | 694.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 2192 |
| Number Of Medicare Beneficiaries With Medical Services | 1736 |
| Total Medical Submitted Charge Amount | 2158996.35 |
| Total Medical Medicare Allowed Amount | 479988.7 |
| Total Medical Medicare Payment Amount | 367397.18 |
| Total Medical Medicare Standardized Payment Amount | 322162.27 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 340 |
| Number Of Beneficiaries Age 65 to 74 | 910 |
| Number Of Beneficiaries Age 75 to 84 | 396 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 1085 |
| Number Of Male Beneficiaries | 651 |
| Number Of Non Hispanic White Beneficiaries | 1091 |
| Number Of Black or African American Beneficiaries | 223 |
| Number Of AsianPacific Islander Beneficiaries | 208 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1209 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 527 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9217 |