| National Provider Identifier [NPI]: | 1467421917 |
| Last Name Of The Provider | MANSFIELD |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 406 9TH AVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921017276 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 3670 |
| Number Of Medicare Beneficiaries | 1932 |
| Total Submitted Charge Amount | 689823.61 |
| Total Medicare Allowed Amount | 293376.83 |
| Total Medicare Payment Amount | 239564.57 |
| Total Medicare Standardized Payment Amount | 225634.69 |
| 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 | 108 |
| Number Of Medical Services | 3670 |
| Number Of Medicare Beneficiaries With Medical Services | 1932 |
| Total Medical Submitted Charge Amount | 689823.61 |
| Total Medical Medicare Allowed Amount | 293376.83 |
| Total Medical Medicare Payment Amount | 239564.57 |
| Total Medical Medicare Standardized Payment Amount | 225634.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 246 |
| Number Of Beneficiaries Age 65 to 74 | 934 |
| Number Of Beneficiaries Age 75 to 84 | 587 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 1477 |
| Number Of Male Beneficiaries | 455 |
| Number Of Non Hispanic White Beneficiaries | 1257 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | 149 |
| Number Of Hispanic Beneficiaries | 409 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1347 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 585 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0744 |