| National Provider Identifier [NPI]: | 1114188893 |
| Last Name Of The Provider | PACE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9501 ROOSEVELT BLVD |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191141025 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2978 |
| Number Of Medicare Beneficiaries | 877 |
| Total Submitted Charge Amount | 321770 |
| Total Medicare Allowed Amount | 209524.09 |
| Total Medicare Payment Amount | 163489.12 |
| Total Medicare Standardized Payment Amount | 139733.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 863 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 26498.5 |
| Total Drug Medicare AllowedAmount | 2992.99 |
| Total Drug Medicare PaymentAmount | 2407.85 |
| Total Drug Medicare Standardized Payment Amount | 2407.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 2115 |
| Number Of Medicare Beneficiaries With Medical Services | 877 |
| Total Medical Submitted Charge Amount | 295271.5 |
| Total Medical Medicare Allowed Amount | 206531.1 |
| Total Medical Medicare Payment Amount | 161081.27 |
| Total Medical Medicare Standardized Payment Amount | 137326.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 197 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 425 |
| Number Of Male Beneficiaries | 452 |
| Number Of Non Hispanic White Beneficiaries | 719 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 374 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.9284 |