| National Provider Identifier [NPI]: | 1427091016 |
| Last Name Of The Provider | DEMARTINI |
| First Name Of The Provider | WILLIAM |
| 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 | 250 BON AIR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENBRAE |
| Zip Code Of The Provider | 949041702 |
| 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 | 213 |
| Number Of Services | 5924 |
| Number Of Medicare Beneficiaries | 3308 |
| Total Submitted Charge Amount | 682812 |
| Total Medicare Allowed Amount | 173263.9 |
| Total Medicare Payment Amount | 133386.9 |
| Total Medicare Standardized Payment Amount | 129090.84 |
| 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 | 213 |
| Number Of Medical Services | 5924 |
| Number Of Medicare Beneficiaries With Medical Services | 3308 |
| Total Medical Submitted Charge Amount | 682812 |
| Total Medical Medicare Allowed Amount | 173263.9 |
| Total Medical Medicare Payment Amount | 133386.9 |
| Total Medical Medicare Standardized Payment Amount | 129090.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 366 |
| Number Of Beneficiaries Age 65 to 74 | 1250 |
| Number Of Beneficiaries Age 75 to 84 | 957 |
| Number Of Beneficiaries Age Greater 84 | 735 |
| Number Of Female Beneficiaries | 2018 |
| Number Of Male Beneficiaries | 1290 |
| Number Of Non Hispanic White Beneficiaries | 2911 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | 87 |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2657 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 651 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3977 |