| National Provider Identifier [NPI]: | 1366413486 |
| Last Name Of The Provider | FIFE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9205 SW BARNES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972256603 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 3487.5 |
| Number Of Medicare Beneficiaries | 2479 |
| Total Submitted Charge Amount | 572197 |
| Total Medicare Allowed Amount | 160020.54 |
| Total Medicare Payment Amount | 123195.35 |
| Total Medicare Standardized Payment Amount | 123336.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 75.5 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 467.5 |
| Total Drug Medicare AllowedAmount | 38.81 |
| Total Drug Medicare PaymentAmount | 30.43 |
| Total Drug Medicare Standardized Payment Amount | 30.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 3412 |
| Number Of Medicare Beneficiaries With Medical Services | 2479 |
| Total Medical Submitted Charge Amount | 571729.5 |
| Total Medical Medicare Allowed Amount | 159981.73 |
| Total Medical Medicare Payment Amount | 123164.92 |
| Total Medical Medicare Standardized Payment Amount | 123305.96 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 362 |
| Number Of Beneficiaries Age 65 to 74 | 1045 |
| Number Of Beneficiaries Age 75 to 84 | 696 |
| Number Of Beneficiaries Age Greater 84 | 376 |
| Number Of Female Beneficiaries | 1584 |
| Number Of Male Beneficiaries | 895 |
| Number Of Non Hispanic White Beneficiaries | 2229 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 76 |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1943 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 536 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3901 |