| National Provider Identifier [NPI]: | 1821235425 |
| Last Name Of The Provider | STACEY |
| First Name Of The Provider | HELEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2255 YGNACIO VALLEY RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 945983343 |
| 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 | 15 |
| Number Of Services | 142 |
| Number Of Medicare Beneficiaries | 82 |
| Total Submitted Charge Amount | 22807 |
| Total Medicare Allowed Amount | 12299.72 |
| Total Medicare Payment Amount | 9491.98 |
| Total Medicare Standardized Payment Amount | 8405.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1312 |
| Total Drug Medicare AllowedAmount | 867.47 |
| Total Drug Medicare PaymentAmount | 849.59 |
| Total Drug Medicare Standardized Payment Amount | 849.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 126 |
| Number Of Medicare Beneficiaries With Medical Services | 82 |
| Total Medical Submitted Charge Amount | 21495 |
| Total Medical Medicare Allowed Amount | 11432.25 |
| Total Medical Medicare Payment Amount | 8642.39 |
| Total Medical Medicare Standardized Payment Amount | 7555.59 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0436 |