| National Provider Identifier [NPI]: | 1457538498 |
| Last Name Of The Provider | SACKS |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1229 MADISON ST |
| Street Address 2 Of The Provider | SUITE 900 |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981043586 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 4239 |
| Number Of Medicare Beneficiaries | 1719 |
| Total Submitted Charge Amount | 258592.88 |
| Total Medicare Allowed Amount | 87267.13 |
| Total Medicare Payment Amount | 65264.39 |
| Total Medicare Standardized Payment Amount | 63153.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1590 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 3754 |
| Total Drug Medicare AllowedAmount | 345.17 |
| Total Drug Medicare PaymentAmount | 270.6 |
| Total Drug Medicare Standardized Payment Amount | 270.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 2649 |
| Number Of Medicare Beneficiaries With Medical Services | 1719 |
| Total Medical Submitted Charge Amount | 254838.88 |
| Total Medical Medicare Allowed Amount | 86921.96 |
| Total Medical Medicare Payment Amount | 64993.79 |
| Total Medical Medicare Standardized Payment Amount | 62882.88 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 305 |
| Number Of Beneficiaries Age 65 to 74 | 590 |
| Number Of Beneficiaries Age 75 to 84 | 468 |
| Number Of Beneficiaries Age Greater 84 | 356 |
| Number Of Female Beneficiaries | 995 |
| Number Of Male Beneficiaries | 724 |
| Number Of Non Hispanic White Beneficiaries | 1249 |
| Number Of Black or African American Beneficiaries | 172 |
| Number Of AsianPacific Islander Beneficiaries | 163 |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 486 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9456 |