| National Provider Identifier [NPI]: | 1932192242 |
| Last Name Of The Provider | FAER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 411 30TH ST |
| Street Address 2 Of The Provider | #508 |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 946093310 |
| 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 | 130 |
| Number Of Services | 4267 |
| Number Of Medicare Beneficiaries | 1229 |
| Total Submitted Charge Amount | 399536.7 |
| Total Medicare Allowed Amount | 128940.1 |
| Total Medicare Payment Amount | 99358.3 |
| Total Medicare Standardized Payment Amount | 84624.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2106 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 2106 |
| Total Drug Medicare AllowedAmount | 590.24 |
| Total Drug Medicare PaymentAmount | 462.75 |
| Total Drug Medicare Standardized Payment Amount | 462.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 2161 |
| Number Of Medicare Beneficiaries With Medical Services | 1229 |
| Total Medical Submitted Charge Amount | 397430.7 |
| Total Medical Medicare Allowed Amount | 128349.86 |
| Total Medical Medicare Payment Amount | 98895.55 |
| Total Medical Medicare Standardized Payment Amount | 84162.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 251 |
| Number Of Beneficiaries Age 65 to 74 | 548 |
| Number Of Beneficiaries Age 75 to 84 | 287 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 825 |
| Number Of Male Beneficiaries | 404 |
| Number Of Non Hispanic White Beneficiaries | 430 |
| Number Of Black or African American Beneficiaries | 280 |
| Number Of AsianPacific Islander Beneficiaries | 283 |
| Number Of Hispanic Beneficiaries | 201 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 586 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 643 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4641 |