National Provider Identifier [NPI]: |
1942232178 |
Last Name Of The Provider |
PACIOTTI |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2709 HEMLOCK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BREMERTON |
Zip Code Of The Provider |
983102623 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
4428 |
Number Of Medicare Beneficiaries |
1232 |
Total Submitted Charge Amount |
569008 |
Total Medicare Allowed Amount |
196520.09 |
Total Medicare Payment Amount |
144364.29 |
Total Medicare Standardized Payment Amount |
145410.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
97 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
7879 |
Total Drug Medicare AllowedAmount |
4506.43 |
Total Drug Medicare PaymentAmount |
3297.81 |
Total Drug Medicare Standardized Payment Amount |
3297.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
4331 |
Number Of Medicare Beneficiaries With Medical Services |
1232 |
Total Medical Submitted Charge Amount |
561129 |
Total Medical Medicare Allowed Amount |
192013.66 |
Total Medical Medicare Payment Amount |
141066.48 |
Total Medical Medicare Standardized Payment Amount |
142113 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
418 |
Number Of Beneficiaries Age 75 to 84 |
471 |
Number Of Beneficiaries Age Greater 84 |
258 |
Number Of Female Beneficiaries |
549 |
Number Of Male Beneficiaries |
683 |
Number Of Non Hispanic White Beneficiaries |
1161 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
23 |
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
1098 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
47 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5844 |