| National Provider Identifier [NPI]: | 1831364330 |
| Last Name Of The Provider | STANFILL |
| First Name Of The Provider | JOHN |
| 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 | 200 W ARBOR DR # MC8201 |
| Street Address 2 Of The Provider | UCSD MEDICAL GROUP - MC 8201 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921031911 |
| 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 | 186 |
| Number Of Services | 4727 |
| Number Of Medicare Beneficiaries | 3212 |
| Total Submitted Charge Amount | 540129 |
| Total Medicare Allowed Amount | 142108.3 |
| Total Medicare Payment Amount | 109361.77 |
| Total Medicare Standardized Payment Amount | 117387.08 |
| 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 | 186 |
| Number Of Medical Services | 4727 |
| Number Of Medicare Beneficiaries With Medical Services | 3212 |
| Total Medical Submitted Charge Amount | 540129 |
| Total Medical Medicare Allowed Amount | 142108.3 |
| Total Medical Medicare Payment Amount | 109361.77 |
| Total Medical Medicare Standardized Payment Amount | 117387.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 696 |
| Number Of Beneficiaries Age 65 to 74 | 1100 |
| Number Of Beneficiaries Age 75 to 84 | 951 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 1880 |
| Number Of Male Beneficiaries | 1332 |
| Number Of Non Hispanic White Beneficiaries | 2350 |
| Number Of Black or African American Beneficiaries | 786 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 942 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0248 |