| National Provider Identifier [NPI]: | 1205879269 |
| Last Name Of The Provider | STAGG |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1287 FULTON RD |
| Street Address 2 Of The Provider | ST JOSEPH'S URGENT CARE - FULTON CAMPUS |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954014923 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 766 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 130550 |
| Total Medicare Allowed Amount | 66225.26 |
| Total Medicare Payment Amount | 51507.2 |
| Total Medicare Standardized Payment Amount | 46062.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1833 |
| Total Drug Medicare AllowedAmount | 1187.3 |
| Total Drug Medicare PaymentAmount | 1150.8 |
| Total Drug Medicare Standardized Payment Amount | 1150.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 708 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 128717 |
| Total Medical Medicare Allowed Amount | 65037.96 |
| Total Medical Medicare Payment Amount | 50356.4 |
| Total Medical Medicare Standardized Payment Amount | 44911.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 190 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9511 |