| National Provider Identifier [NPI]: | 1114927050 |
| Last Name Of The Provider | FELLER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 74785 US HIGHWAY 111 |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | INDIAN WELLS |
| Zip Code Of The Provider | 922107128 |
| 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 | 127 |
| Number Of Services | 8631 |
| Number Of Medicare Beneficiaries | 1466 |
| Total Submitted Charge Amount | 1832453 |
| Total Medicare Allowed Amount | 503278.63 |
| Total Medicare Payment Amount | 380800.91 |
| Total Medicare Standardized Payment Amount | 361548.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 6450 |
| Number Of Medicare Beneficiaries With Drug Services | 415 |
| Total Drug Submitted ChargeAmount | 88850 |
| Total Drug Medicare AllowedAmount | 4552.26 |
| Total Drug Medicare PaymentAmount | 3561.01 |
| Total Drug Medicare Standardized Payment Amount | 3561.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 2181 |
| Number Of Medicare Beneficiaries With Medical Services | 1466 |
| Total Medical Submitted Charge Amount | 1743603 |
| Total Medical Medicare Allowed Amount | 498726.37 |
| Total Medical Medicare Payment Amount | 377239.9 |
| Total Medical Medicare Standardized Payment Amount | 357987.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 719 |
| Number Of Beneficiaries Age 75 to 84 | 458 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 685 |
| Number Of Male Beneficiaries | 781 |
| Number Of Non Hispanic White Beneficiaries | 1206 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 191 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1210 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 256 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1052 |