| National Provider Identifier [NPI]: | 1609196831 |
| Last Name Of The Provider | STEWART |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 566 S VAN NESS AVE |
| Street Address 2 Of The Provider | APT 21 |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941107312 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 218 |
| Number Of Medicare Beneficiaries | 100 |
| Total Submitted Charge Amount | 80102 |
| Total Medicare Allowed Amount | 23539.68 |
| Total Medicare Payment Amount | 18363.88 |
| Total Medicare Standardized Payment Amount | 17176.4 |
| 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 | 10 |
| Number Of Medical Services | 218 |
| Number Of Medicare Beneficiaries With Medical Services | 100 |
| Total Medical Submitted Charge Amount | 80102 |
| Total Medical Medicare Allowed Amount | 23539.68 |
| Total Medical Medicare Payment Amount | 18363.88 |
| Total Medical Medicare Standardized Payment Amount | 17176.4 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 31 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 26 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.2006 |