| National Provider Identifier [NPI]: | 1548369648 |
| Last Name Of The Provider | FEDERMAN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6699 ALVARADO RD |
| Street Address 2 Of The Provider | SUITE 2308 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921205241 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3286 |
| Number Of Medicare Beneficiaries | 396 |
| Total Submitted Charge Amount | 344008.93 |
| Total Medicare Allowed Amount | 217675.2 |
| Total Medicare Payment Amount | 164957.3 |
| Total Medicare Standardized Payment Amount | 159884.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 116 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 6839.93 |
| Total Drug Medicare AllowedAmount | 5548.17 |
| Total Drug Medicare PaymentAmount | 5379.61 |
| Total Drug Medicare Standardized Payment Amount | 5379.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 3170 |
| Number Of Medicare Beneficiaries With Medical Services | 396 |
| Total Medical Submitted Charge Amount | 337169 |
| Total Medical Medicare Allowed Amount | 212127.03 |
| Total Medical Medicare Payment Amount | 159577.69 |
| Total Medical Medicare Standardized Payment Amount | 154504.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 282 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 70 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 3.2052 |