| National Provider Identifier [NPI]: | 1316920069 |
| Last Name Of The Provider | FERNANDEZ |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 FAIRVIEW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363013008 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 302 |
| Number Of Services | 10088 |
| Number Of Medicare Beneficiaries | 6151 |
| Total Submitted Charge Amount | 2080071 |
| Total Medicare Allowed Amount | 375458.81 |
| Total Medicare Payment Amount | 285986.43 |
| Total Medicare Standardized Payment Amount | 302458.48 |
| 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 | 302 |
| Number Of Medical Services | 10088 |
| Number Of Medicare Beneficiaries With Medical Services | 6151 |
| Total Medical Submitted Charge Amount | 2080071 |
| Total Medical Medicare Allowed Amount | 375458.81 |
| Total Medical Medicare Payment Amount | 285986.43 |
| Total Medical Medicare Standardized Payment Amount | 302458.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1368 |
| Number Of Beneficiaries Age 65 to 74 | 2280 |
| Number Of Beneficiaries Age 75 to 84 | 1767 |
| Number Of Beneficiaries Age Greater 84 | 736 |
| Number Of Female Beneficiaries | 3449 |
| Number Of Male Beneficiaries | 2702 |
| Number Of Non Hispanic White Beneficiaries | 4799 |
| Number Of Black or African American Beneficiaries | 1269 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4148 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2003 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6383 |