| National Provider Identifier [NPI]: | 1578529012 |
| Last Name Of The Provider | CEDERSTROM |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 NEWPORT CENTER DR |
| Street Address 2 Of The Provider | SUITE 608 |
| City Of The Provider | NEWPORT BEACH |
| Zip Code Of The Provider | 926607601 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 8508 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 642074 |
| Total Medicare Allowed Amount | 326259.18 |
| Total Medicare Payment Amount | 265135.48 |
| Total Medicare Standardized Payment Amount | 247529.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 323 |
| Number Of Medicare Beneficiaries With Drug Services | 246 |
| Total Drug Submitted ChargeAmount | 17725 |
| Total Drug Medicare AllowedAmount | 12503.52 |
| Total Drug Medicare PaymentAmount | 12196.55 |
| Total Drug Medicare Standardized Payment Amount | 12196.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 8185 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 624349 |
| Total Medical Medicare Allowed Amount | 313755.66 |
| Total Medical Medicare Payment Amount | 252938.93 |
| Total Medical Medicare Standardized Payment Amount | 235333.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 355 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 392 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8426 |