| National Provider Identifier [NPI]: | 1326030040 |
| Last Name Of The Provider | PACE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12070 OLD LINE CTR |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | WALDORF |
| Zip Code Of The Provider | 206022513 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3794 |
| Number Of Medicare Beneficiaries | 943 |
| Total Submitted Charge Amount | 306355 |
| Total Medicare Allowed Amount | 223075.69 |
| Total Medicare Payment Amount | 151052.38 |
| Total Medicare Standardized Payment Amount | 149443.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 383 |
| Number Of Medicare Beneficiaries With Drug Services | 313 |
| Total Drug Submitted ChargeAmount | 10476 |
| Total Drug Medicare AllowedAmount | 9274.42 |
| Total Drug Medicare PaymentAmount | 8997.78 |
| Total Drug Medicare Standardized Payment Amount | 8997.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 3411 |
| Number Of Medicare Beneficiaries With Medical Services | 943 |
| Total Medical Submitted Charge Amount | 295879 |
| Total Medical Medicare Allowed Amount | 213801.27 |
| Total Medical Medicare Payment Amount | 142054.6 |
| Total Medical Medicare Standardized Payment Amount | 140445.91 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 171 |
| Number Of Beneficiaries Age 65 to 74 | 516 |
| Number Of Beneficiaries Age 75 to 84 | 199 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 553 |
| Number Of Male Beneficiaries | 390 |
| Number Of Non Hispanic White Beneficiaries | 532 |
| Number Of Black or African American Beneficiaries | 379 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 768 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.124 |