| National Provider Identifier [NPI]: | 1710981634 |
| Last Name Of The Provider | FELL |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4816A NE THURSTON WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | VANCOUVER |
| Zip Code Of The Provider | 98662 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 10298 |
| Number Of Medicare Beneficiaries | 1553 |
| Total Submitted Charge Amount | 431660.63 |
| Total Medicare Allowed Amount | 130655.75 |
| Total Medicare Payment Amount | 95716.87 |
| Total Medicare Standardized Payment Amount | 97063.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7925 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 2983.5 |
| Total Drug Medicare AllowedAmount | 1672.82 |
| Total Drug Medicare PaymentAmount | 1167.32 |
| Total Drug Medicare Standardized Payment Amount | 1167.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 2373 |
| Number Of Medicare Beneficiaries With Medical Services | 1553 |
| Total Medical Submitted Charge Amount | 428677.13 |
| Total Medical Medicare Allowed Amount | 128982.93 |
| Total Medical Medicare Payment Amount | 94549.55 |
| Total Medical Medicare Standardized Payment Amount | 95896.06 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 546 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 939 |
| Number Of Male Beneficiaries | 614 |
| Number Of Non Hispanic White Beneficiaries | 1415 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1047 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 506 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5835 |