| National Provider Identifier [NPI]: | 1033146758 |
| Last Name Of The Provider | FISH |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2125 OAK GROVE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 945982536 |
| 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 | 7 |
| Number Of Services | 3214 |
| Number Of Medicare Beneficiaries | 1529 |
| Total Submitted Charge Amount | 256430 |
| Total Medicare Allowed Amount | 74255.91 |
| Total Medicare Payment Amount | 66383.48 |
| Total Medicare Standardized Payment Amount | 61397.7 |
| 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 | 7 |
| Number Of Medical Services | 3214 |
| Number Of Medicare Beneficiaries With Medical Services | 1529 |
| Total Medical Submitted Charge Amount | 256430 |
| Total Medical Medicare Allowed Amount | 74255.91 |
| Total Medical Medicare Payment Amount | 66383.48 |
| Total Medical Medicare Standardized Payment Amount | 61397.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 967 |
| Number Of Beneficiaries Age 75 to 84 | 419 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 1517 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | 1378 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 62 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1488 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 2 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 10 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7591 |