| National Provider Identifier [NPI]: | 1568621449 |
| Last Name Of The Provider | MARSHALL |
| First Name Of The Provider | DUSTYN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 505 PARNASSUS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941432204 |
| 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 | 266 |
| Number Of Services | 11730 |
| Number Of Medicare Beneficiaries | 2768 |
| Total Submitted Charge Amount | 1185223.39 |
| Total Medicare Allowed Amount | 246850.48 |
| Total Medicare Payment Amount | 186618.03 |
| Total Medicare Standardized Payment Amount | 185926.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 6355 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 6355 |
| Total Drug Medicare AllowedAmount | 1157 |
| Total Drug Medicare PaymentAmount | 803.58 |
| Total Drug Medicare Standardized Payment Amount | 803.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 265 |
| Number Of Medical Services | 5375 |
| Number Of Medicare Beneficiaries With Medical Services | 2768 |
| Total Medical Submitted Charge Amount | 1178868.39 |
| Total Medical Medicare Allowed Amount | 245693.48 |
| Total Medical Medicare Payment Amount | 185814.45 |
| Total Medical Medicare Standardized Payment Amount | 185122.7 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 612 |
| Number Of Beneficiaries Age 65 to 74 | 898 |
| Number Of Beneficiaries Age 75 to 84 | 792 |
| Number Of Beneficiaries Age Greater 84 | 466 |
| Number Of Female Beneficiaries | 1468 |
| Number Of Male Beneficiaries | 1300 |
| Number Of Non Hispanic White Beneficiaries | 1857 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | 137 |
| Number Of Hispanic Beneficiaries | 633 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1257 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1511 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0934 |