| National Provider Identifier [NPI]: | 1689681181 |
| Last Name Of The Provider | FEIWELL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 SOTOYOME ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954054823 |
| 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 | 222 |
| Number Of Services | 14295 |
| Number Of Medicare Beneficiaries | 4444 |
| Total Submitted Charge Amount | 675539.5 |
| Total Medicare Allowed Amount | 303112.48 |
| Total Medicare Payment Amount | 223805.03 |
| Total Medicare Standardized Payment Amount | 219966.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7195 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 17125 |
| Total Drug Medicare AllowedAmount | 2001.12 |
| Total Drug Medicare PaymentAmount | 1568.83 |
| Total Drug Medicare Standardized Payment Amount | 1568.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 219 |
| Number Of Medical Services | 7100 |
| Number Of Medicare Beneficiaries With Medical Services | 4444 |
| Total Medical Submitted Charge Amount | 658414.5 |
| Total Medical Medicare Allowed Amount | 301111.36 |
| Total Medical Medicare Payment Amount | 222236.2 |
| Total Medical Medicare Standardized Payment Amount | 218397.65 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 661 |
| Number Of Beneficiaries Age 65 to 74 | 1578 |
| Number Of Beneficiaries Age 75 to 84 | 1260 |
| Number Of Beneficiaries Age Greater 84 | 945 |
| Number Of Female Beneficiaries | 2629 |
| Number Of Male Beneficiaries | 1815 |
| Number Of Non Hispanic White Beneficiaries | 3898 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 79 |
| Number Of Hispanic Beneficiaries | 300 |
| Number Of American Indian Alaska Native Beneficiaries | 41 |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1117 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5488 |