| National Provider Identifier [NPI]: | 1013925577 |
| Last Name Of The Provider | PRIMACK |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3181 SW SAM JACKSON PARK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972393011 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 2985 |
| Number Of Medicare Beneficiaries | 1854 |
| Total Submitted Charge Amount | 117840 |
| Total Medicare Allowed Amount | 46803.67 |
| Total Medicare Payment Amount | 35371.55 |
| Total Medicare Standardized Payment Amount | 35655.44 |
| 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 | 54 |
| Number Of Medical Services | 2985 |
| Number Of Medicare Beneficiaries With Medical Services | 1854 |
| Total Medical Submitted Charge Amount | 117840 |
| Total Medical Medicare Allowed Amount | 46803.67 |
| Total Medical Medicare Payment Amount | 35371.55 |
| Total Medical Medicare Standardized Payment Amount | 35655.44 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 535 |
| Number Of Beneficiaries Age 65 to 74 | 741 |
| Number Of Beneficiaries Age 75 to 84 | 402 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 860 |
| Number Of Male Beneficiaries | 994 |
| Number Of Non Hispanic White Beneficiaries | 1608 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | 29 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1300 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 554 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9954 |