| National Provider Identifier [NPI]: | 1639103138 |
| Last Name Of The Provider | FERNANDEZ |
| First Name Of The Provider | GEOVER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 N PROSPECT AVE |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | REDONDO BEACH |
| Zip Code Of The Provider | 902773041 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 6277 |
| Number Of Medicare Beneficiaries | 1021 |
| Total Submitted Charge Amount | 2788682.14 |
| Total Medicare Allowed Amount | 1221128.03 |
| Total Medicare Payment Amount | 939337.14 |
| Total Medicare Standardized Payment Amount | 776166.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 172.8 |
| Total Drug Medicare AllowedAmount | 70.93 |
| Total Drug Medicare PaymentAmount | 54.24 |
| Total Drug Medicare Standardized Payment Amount | 54.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 6237 |
| Number Of Medicare Beneficiaries With Medical Services | 1021 |
| Total Medical Submitted Charge Amount | 2788509.34 |
| Total Medical Medicare Allowed Amount | 1221057.1 |
| Total Medical Medicare Payment Amount | 939282.9 |
| Total Medical Medicare Standardized Payment Amount | 776111.95 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 402 |
| Number Of Beneficiaries Age 75 to 84 | 319 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 467 |
| Number Of Male Beneficiaries | 554 |
| Number Of Non Hispanic White Beneficiaries | 828 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 153 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 765 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 256 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2402 |