| National Provider Identifier [NPI]: | 1689628687 |
| Last Name Of The Provider | ABEDON |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 SULLIVAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALY CITY |
| Zip Code Of The Provider | 940152200 |
| 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 | 227 |
| Number Of Services | 3021 |
| Number Of Medicare Beneficiaries | 1482 |
| Total Submitted Charge Amount | 772220 |
| Total Medicare Allowed Amount | 233460.95 |
| Total Medicare Payment Amount | 181816.4 |
| Total Medicare Standardized Payment Amount | 153534.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 227 |
| Number Of Medical Services | 3021 |
| Number Of Medicare Beneficiaries With Medical Services | 1482 |
| Total Medical Submitted Charge Amount | 772220 |
| Total Medical Medicare Allowed Amount | 233460.95 |
| Total Medical Medicare Payment Amount | 181816.4 |
| Total Medical Medicare Standardized Payment Amount | 153534.91 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | 500 |
| Number Of Beneficiaries Age 75 to 84 | 475 |
| Number Of Beneficiaries Age Greater 84 | 344 |
| Number Of Female Beneficiaries | 905 |
| Number Of Male Beneficiaries | 577 |
| Number Of Non Hispanic White Beneficiaries | 649 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | 387 |
| Number Of Hispanic Beneficiaries | 280 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 962 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 520 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1298 |