| National Provider Identifier [NPI]: | 1245289545 |
| Last Name Of The Provider | FAN |
| First Name Of The Provider | DALI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4860 Y ST STE 2820 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958172307 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 6147 |
| Number Of Medicare Beneficiaries | 3411 |
| Total Submitted Charge Amount | 674936 |
| Total Medicare Allowed Amount | 167780.74 |
| Total Medicare Payment Amount | 126247.63 |
| Total Medicare Standardized Payment Amount | 124097.74 |
| 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 | 50 |
| Number Of Medical Services | 6147 |
| Number Of Medicare Beneficiaries With Medical Services | 3411 |
| Total Medical Submitted Charge Amount | 674936 |
| Total Medical Medicare Allowed Amount | 167780.74 |
| Total Medical Medicare Payment Amount | 126247.63 |
| Total Medical Medicare Standardized Payment Amount | 124097.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 818 |
| Number Of Beneficiaries Age 65 to 74 | 1182 |
| Number Of Beneficiaries Age 75 to 84 | 954 |
| Number Of Beneficiaries Age Greater 84 | 457 |
| Number Of Female Beneficiaries | 1623 |
| Number Of Male Beneficiaries | 1788 |
| Number Of Non Hispanic White Beneficiaries | 2217 |
| Number Of Black or African American Beneficiaries | 442 |
| Number Of AsianPacific Islander Beneficiaries | 308 |
| Number Of Hispanic Beneficiaries | 345 |
| Number Of American Indian Alaska Native Beneficiaries | 29 |
| Number Of Beneficiaries With Race Not Else where Classified | 70 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1965 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1446 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1759 |