| National Provider Identifier [NPI]: | 1588736706 |
| Last Name Of The Provider | BACANI |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | NP-C, ACNS, MSN |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 540 W 5TH ST |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | ODESSA |
| Zip Code Of The Provider | 797615034 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 978 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 176572.5 |
| Total Medicare Allowed Amount | 45336.4 |
| Total Medicare Payment Amount | 32891.36 |
| Total Medicare Standardized Payment Amount | 40286.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 439 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 5843.5 |
| Total Drug Medicare AllowedAmount | 179.04 |
| Total Drug Medicare PaymentAmount | 152.09 |
| Total Drug Medicare Standardized Payment Amount | 152.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 539 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 170729 |
| Total Medical Medicare Allowed Amount | 45157.36 |
| Total Medical Medicare Payment Amount | 32739.27 |
| Total Medical Medicare Standardized Payment Amount | 40134.71 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 118 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 107 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 139 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6 |