| National Provider Identifier [NPI]: | 1831160001 |
| Last Name Of The Provider | PASALICH |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5001 US HIGHWAY 30 W STE D |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468189701 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 216 |
| Number Of Services | 13588 |
| Number Of Medicare Beneficiaries | 9125 |
| Total Submitted Charge Amount | 1003614.31 |
| Total Medicare Allowed Amount | 261462.32 |
| Total Medicare Payment Amount | 195858.07 |
| Total Medicare Standardized Payment Amount | 205740.93 |
| 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 | 216 |
| Number Of Medical Services | 13588 |
| Number Of Medicare Beneficiaries With Medical Services | 9125 |
| Total Medical Submitted Charge Amount | 1003614.31 |
| Total Medical Medicare Allowed Amount | 261462.32 |
| Total Medical Medicare Payment Amount | 195858.07 |
| Total Medical Medicare Standardized Payment Amount | 205740.93 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1878 |
| Number Of Beneficiaries Age 65 to 74 | 3130 |
| Number Of Beneficiaries Age 75 to 84 | 2516 |
| Number Of Beneficiaries Age Greater 84 | 1601 |
| Number Of Female Beneficiaries | 5627 |
| Number Of Male Beneficiaries | 3498 |
| Number Of Non Hispanic White Beneficiaries | 8454 |
| Number Of Black or African American Beneficiaries | 403 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 121 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 92 |
| Number Of Beneficiaries With Medicare Only Entitlement | 6640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2485 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5663 |