| National Provider Identifier [NPI]: | 1124025572 |
| Last Name Of The Provider | SEIDENWURM |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2801 K ST |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958165120 |
| 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 | 150 |
| Number Of Services | 14524 |
| Number Of Medicare Beneficiaries | 2301 |
| Total Submitted Charge Amount | 2270613.72 |
| Total Medicare Allowed Amount | 374050.67 |
| Total Medicare Payment Amount | 286433.8 |
| Total Medicare Standardized Payment Amount | 274116.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 11492 |
| Number Of Medicare Beneficiaries With Drug Services | 252 |
| Total Drug Submitted ChargeAmount | 33015 |
| Total Drug Medicare AllowedAmount | 5789.52 |
| Total Drug Medicare PaymentAmount | 4505.97 |
| Total Drug Medicare Standardized Payment Amount | 4505.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 144 |
| Number Of Medical Services | 3032 |
| Number Of Medicare Beneficiaries With Medical Services | 2301 |
| Total Medical Submitted Charge Amount | 2237598.72 |
| Total Medical Medicare Allowed Amount | 368261.15 |
| Total Medical Medicare Payment Amount | 281927.83 |
| Total Medical Medicare Standardized Payment Amount | 269610.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 357 |
| Number Of Beneficiaries Age 65 to 74 | 980 |
| Number Of Beneficiaries Age 75 to 84 | 663 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 1411 |
| Number Of Male Beneficiaries | 890 |
| Number Of Non Hispanic White Beneficiaries | 1645 |
| Number Of Black or African American Beneficiaries | 123 |
| Number Of AsianPacific Islander Beneficiaries | 267 |
| Number Of Hispanic Beneficiaries | 202 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 619 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2505 |