| National Provider Identifier [NPI]: | 1265478564 |
| Last Name Of The Provider | STEIN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 N TUSTIN AVE |
| Street Address 2 Of The Provider | BLDG. A |
| City Of The Provider | SANTA ANA |
| Zip Code Of The Provider | 927053509 |
| 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 | 131 |
| Number Of Services | 12943 |
| Number Of Medicare Beneficiaries | 1028 |
| Total Submitted Charge Amount | 1123690.69 |
| Total Medicare Allowed Amount | 321517.37 |
| Total Medicare Payment Amount | 243181.39 |
| Total Medicare Standardized Payment Amount | 222400.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11406 |
| Number Of Medicare Beneficiaries With Drug Services | 150 |
| Total Drug Submitted ChargeAmount | 15686 |
| Total Drug Medicare AllowedAmount | 3292.37 |
| Total Drug Medicare PaymentAmount | 2559.62 |
| Total Drug Medicare Standardized Payment Amount | 2559.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 1537 |
| Number Of Medicare Beneficiaries With Medical Services | 1028 |
| Total Medical Submitted Charge Amount | 1108004.69 |
| Total Medical Medicare Allowed Amount | 318225 |
| Total Medical Medicare Payment Amount | 240621.77 |
| Total Medical Medicare Standardized Payment Amount | 219840.88 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 473 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 611 |
| Number Of Male Beneficiaries | 417 |
| Number Of Non Hispanic White Beneficiaries | 602 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 158 |
| Number Of Hispanic Beneficiaries | 232 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 612 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 416 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2408 |