| National Provider Identifier [NPI]: | 1437215803 |
| Last Name Of The Provider | AXLINE |
| First Name Of The Provider | STANTON |
| 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 | 2001 SANTA MONICA BLVD |
| Street Address 2 Of The Provider | 665W |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904042102 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 4247 |
| Number Of Medicare Beneficiaries | 512 |
| Total Submitted Charge Amount | 917000 |
| Total Medicare Allowed Amount | 466319.21 |
| Total Medicare Payment Amount | 364803.48 |
| Total Medicare Standardized Payment Amount | 343006.53 |
| 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 | 14 |
| Number Of Medical Services | 4247 |
| Number Of Medicare Beneficiaries With Medical Services | 512 |
| Total Medical Submitted Charge Amount | 917000 |
| Total Medical Medicare Allowed Amount | 466319.21 |
| Total Medical Medicare Payment Amount | 364803.48 |
| Total Medical Medicare Standardized Payment Amount | 343006.53 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 264 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 370 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 45 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 3.3044 |