| National Provider Identifier [NPI]: | 1811931611 |
| Last Name Of The Provider | HOLLETT |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 170 ALAMEDA DE LAS PULGAS |
| Street Address 2 Of The Provider | |
| City Of The Provider | REDWOOD CITY |
| Zip Code Of The Provider | 940622751 |
| 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 | 151 |
| Number Of Services | 4392 |
| Number Of Medicare Beneficiaries | 2319 |
| Total Submitted Charge Amount | 548136 |
| Total Medicare Allowed Amount | 148406.43 |
| Total Medicare Payment Amount | 114825.45 |
| Total Medicare Standardized Payment Amount | 103641.91 |
| 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 | 151 |
| Number Of Medical Services | 4392 |
| Number Of Medicare Beneficiaries With Medical Services | 2319 |
| Total Medical Submitted Charge Amount | 548136 |
| Total Medical Medicare Allowed Amount | 148406.43 |
| Total Medical Medicare Payment Amount | 114825.45 |
| Total Medical Medicare Standardized Payment Amount | 103641.91 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 788 |
| Number Of Beneficiaries Age 75 to 84 | 755 |
| Number Of Beneficiaries Age Greater 84 | 656 |
| Number Of Female Beneficiaries | 1436 |
| Number Of Male Beneficiaries | 883 |
| Number Of Non Hispanic White Beneficiaries | 1945 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 123 |
| Number Of Hispanic Beneficiaries | 161 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4726 |