| National Provider Identifier [NPI]: | 1245313683 |
| Last Name Of The Provider | FEDAK |
| First Name Of The Provider | MARIAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 E CESAR E CHAVEZ AVE |
| Street Address 2 Of The Provider | SUITE 3300 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900332424 |
| 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 | 20 |
| Number Of Services | 1963 |
| Number Of Medicare Beneficiaries | 312 |
| Total Submitted Charge Amount | 239372.65 |
| Total Medicare Allowed Amount | 173196.61 |
| Total Medicare Payment Amount | 125263.32 |
| Total Medicare Standardized Payment Amount | 116939.11 |
| 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 | 20 |
| Number Of Medical Services | 1963 |
| Number Of Medicare Beneficiaries With Medical Services | 312 |
| Total Medical Submitted Charge Amount | 239372.65 |
| Total Medical Medicare Allowed Amount | 173196.61 |
| Total Medical Medicare Payment Amount | 125263.32 |
| Total Medical Medicare Standardized Payment Amount | 116939.11 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 74 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 51 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 55 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.4081 |