| National Provider Identifier [NPI]: | 1295734838 |
| Last Name Of The Provider | CAMBRAY-FORKER |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 431 S BATAVIA ST |
| Street Address 2 Of The Provider | STE. 103 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928683936 |
| 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 | 144 |
| Number Of Services | 9423 |
| Number Of Medicare Beneficiaries | 1300 |
| Total Submitted Charge Amount | 535336.11 |
| Total Medicare Allowed Amount | 194635.14 |
| Total Medicare Payment Amount | 144693.44 |
| Total Medicare Standardized Payment Amount | 125186.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 7447 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 12485 |
| Total Drug Medicare AllowedAmount | 2867.2 |
| Total Drug Medicare PaymentAmount | 2247.86 |
| Total Drug Medicare Standardized Payment Amount | 2247.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 1976 |
| Number Of Medicare Beneficiaries With Medical Services | 1300 |
| Total Medical Submitted Charge Amount | 522851.11 |
| Total Medical Medicare Allowed Amount | 191767.94 |
| Total Medical Medicare Payment Amount | 142445.58 |
| Total Medical Medicare Standardized Payment Amount | 122938.46 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 452 |
| Number Of Beneficiaries Age 75 to 84 | 458 |
| Number Of Beneficiaries Age Greater 84 | 288 |
| Number Of Female Beneficiaries | 728 |
| Number Of Male Beneficiaries | 572 |
| Number Of Non Hispanic White Beneficiaries | 928 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 108 |
| Number Of Hispanic Beneficiaries | 213 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1020 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 280 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8031 |