| National Provider Identifier [NPI]: | 1184660565 |
| Last Name Of The Provider | HAINES |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6305 COYLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARMICHAEL |
| Zip Code Of The Provider | 956080438 |
| 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 | 10560 |
| Number Of Medicare Beneficiaries | 4718 |
| Total Submitted Charge Amount | 1075488.4 |
| Total Medicare Allowed Amount | 269956.73 |
| Total Medicare Payment Amount | 219556.75 |
| Total Medicare Standardized Payment Amount | 215761.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2890 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 3070 |
| Total Drug Medicare AllowedAmount | 537.34 |
| Total Drug Medicare PaymentAmount | 421.24 |
| Total Drug Medicare Standardized Payment Amount | 421.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 148 |
| Number Of Medical Services | 7670 |
| Number Of Medicare Beneficiaries With Medical Services | 4718 |
| Total Medical Submitted Charge Amount | 1072418.4 |
| Total Medical Medicare Allowed Amount | 269419.39 |
| Total Medical Medicare Payment Amount | 219135.51 |
| Total Medical Medicare Standardized Payment Amount | 215339.9 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1038 |
| Number Of Beneficiaries Age 65 to 74 | 1605 |
| Number Of Beneficiaries Age 75 to 84 | 1235 |
| Number Of Beneficiaries Age Greater 84 | 840 |
| Number Of Female Beneficiaries | 2928 |
| Number Of Male Beneficiaries | 1790 |
| Number Of Non Hispanic White Beneficiaries | 3224 |
| Number Of Black or African American Beneficiaries | 466 |
| Number Of AsianPacific Islander Beneficiaries | 481 |
| Number Of Hispanic Beneficiaries | 426 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 93 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2654 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2064 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8201 |