| National Provider Identifier [NPI]: | 1417942905 |
| Last Name Of The Provider | FASTENBERG |
| First Name Of The Provider | NATHANIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6111 E ARBOR AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852066059 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Medical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 74976 |
| Number Of Medicare Beneficiaries | 363 |
| Total Submitted Charge Amount | 2118317 |
| Total Medicare Allowed Amount | 1095570.51 |
| Total Medicare Payment Amount | 856318.83 |
| Total Medicare Standardized Payment Amount | 855797.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 61 |
| Number Of Drug Services | 73111 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 1826086 |
| Total Drug Medicare AllowedAmount | 942970.09 |
| Total Drug Medicare PaymentAmount | 739221.79 |
| Total Drug Medicare Standardized Payment Amount | 739221.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1865 |
| Number Of Medicare Beneficiaries With Medical Services | 363 |
| Total Medical Submitted Charge Amount | 292231 |
| Total Medical Medicare Allowed Amount | 152600.42 |
| Total Medical Medicare Payment Amount | 117097.04 |
| Total Medical Medicare Standardized Payment Amount | 116575.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 170 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 335 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9732 |