| National Provider Identifier [NPI]: | 1881858439 |
| Last Name Of The Provider | FERNANDEZ |
| First Name Of The Provider | MARIFEL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 COMO AVENUE |
| Street Address 2 Of The Provider | MS 31100A - HEALTHPARTNERS COMO CLINIC |
| City Of The Provider | ST PAUL |
| Zip Code Of The Provider | 551081460 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1337 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 68859 |
| Total Medicare Allowed Amount | 25603.25 |
| Total Medicare Payment Amount | 18278.32 |
| Total Medicare Standardized Payment Amount | 18466.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 983 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 10159 |
| Total Drug Medicare AllowedAmount | 5033.41 |
| Total Drug Medicare PaymentAmount | 3912.88 |
| Total Drug Medicare Standardized Payment Amount | 3912.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 354 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 58700 |
| Total Medical Medicare Allowed Amount | 20569.84 |
| Total Medical Medicare Payment Amount | 14365.44 |
| Total Medical Medicare Standardized Payment Amount | 14553.39 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 93 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.047 |