| National Provider Identifier [NPI]: | 1689648073 |
| Last Name Of The Provider | HOLTZMAN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1310 LAS TABLAS RD |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | TEMPLETON |
| Zip Code Of The Provider | 934659737 |
| 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 | 343 |
| Number Of Services | 20752 |
| Number Of Medicare Beneficiaries | 2677 |
| Total Submitted Charge Amount | 1950468.82 |
| Total Medicare Allowed Amount | 501805.26 |
| Total Medicare Payment Amount | 383570.09 |
| Total Medicare Standardized Payment Amount | 375667.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 15543 |
| Number Of Medicare Beneficiaries With Drug Services | 225 |
| Total Drug Submitted ChargeAmount | 42230 |
| Total Drug Medicare AllowedAmount | 6196.75 |
| Total Drug Medicare PaymentAmount | 4817.73 |
| Total Drug Medicare Standardized Payment Amount | 4817.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 337 |
| Number Of Medical Services | 5209 |
| Number Of Medicare Beneficiaries With Medical Services | 2675 |
| Total Medical Submitted Charge Amount | 1908238.82 |
| Total Medical Medicare Allowed Amount | 495608.51 |
| Total Medical Medicare Payment Amount | 378752.36 |
| Total Medical Medicare Standardized Payment Amount | 370849.32 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 1038 |
| Number Of Beneficiaries Age 75 to 84 | 823 |
| Number Of Beneficiaries Age Greater 84 | 461 |
| Number Of Female Beneficiaries | 1527 |
| Number Of Male Beneficiaries | 1150 |
| Number Of Non Hispanic White Beneficiaries | 2325 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 242 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 510 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4265 |