| National Provider Identifier [NPI]: | 1851456081 |
| Last Name Of The Provider | IRIZARRY |
| First Name Of The Provider | FERNANDO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 LILLY RD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065115 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 365 |
| Number Of Medicare Beneficiaries | 89 |
| Total Submitted Charge Amount | 54369 |
| Total Medicare Allowed Amount | 22801.3 |
| Total Medicare Payment Amount | 16876.82 |
| Total Medicare Standardized Payment Amount | 15969.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1239 |
| Total Drug Medicare AllowedAmount | 1085.88 |
| Total Drug Medicare PaymentAmount | 1064.12 |
| Total Drug Medicare Standardized Payment Amount | 1064.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 350 |
| Number Of Medicare Beneficiaries With Medical Services | 89 |
| Total Medical Submitted Charge Amount | 53130 |
| Total Medical Medicare Allowed Amount | 21715.42 |
| Total Medical Medicare Payment Amount | 15812.7 |
| Total Medical Medicare Standardized Payment Amount | 14905.43 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 40 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 78 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | |
| 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 | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7439 |