| National Provider Identifier [NPI]: | 1033118336 |
| Last Name Of The Provider | MASOTTO |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 431 S BATAVIA ST |
| Street Address 2 Of The Provider | STE. 103 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928683936 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 36056 |
| Number Of Medicare Beneficiaries | 2822 |
| Total Submitted Charge Amount | 1814557.6 |
| Total Medicare Allowed Amount | 674757.04 |
| Total Medicare Payment Amount | 508690.12 |
| Total Medicare Standardized Payment Amount | 435152.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 30827 |
| Number Of Medicare Beneficiaries With Drug Services | 396 |
| Total Drug Submitted ChargeAmount | 48575 |
| Total Drug Medicare AllowedAmount | 10352.88 |
| Total Drug Medicare PaymentAmount | 8081.59 |
| Total Drug Medicare Standardized Payment Amount | 8081.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 5229 |
| Number Of Medicare Beneficiaries With Medical Services | 2822 |
| Total Medical Submitted Charge Amount | 1765982.6 |
| Total Medical Medicare Allowed Amount | 664404.16 |
| Total Medical Medicare Payment Amount | 500608.53 |
| Total Medical Medicare Standardized Payment Amount | 427070.44 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 238 |
| Number Of Beneficiaries Age 65 to 74 | 1077 |
| Number Of Beneficiaries Age 75 to 84 | 1042 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 1673 |
| Number Of Male Beneficiaries | 1149 |
| Number Of Non Hispanic White Beneficiaries | 2089 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 201 |
| Number Of Hispanic Beneficiaries | 415 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 491 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4785 |