| National Provider Identifier [NPI]: | 1700862539 |
| Last Name Of The Provider | SACCO |
| First Name Of The Provider | DAMON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 BON AIR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENBRAE |
| Zip Code Of The Provider | 949041702 |
| 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 | 61 |
| Number Of Services | 4609 |
| Number Of Medicare Beneficiaries | 1779 |
| Total Submitted Charge Amount | 782026.3 |
| Total Medicare Allowed Amount | 207754.03 |
| Total Medicare Payment Amount | 160754.34 |
| Total Medicare Standardized Payment Amount | 147489.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2262 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1659.3 |
| Total Drug Medicare AllowedAmount | 914.48 |
| Total Drug Medicare PaymentAmount | 693.41 |
| Total Drug Medicare Standardized Payment Amount | 693.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2347 |
| Number Of Medicare Beneficiaries With Medical Services | 1779 |
| Total Medical Submitted Charge Amount | 780367 |
| Total Medical Medicare Allowed Amount | 206839.55 |
| Total Medical Medicare Payment Amount | 160060.93 |
| Total Medical Medicare Standardized Payment Amount | 146795.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 169 |
| Number Of Beneficiaries Age 65 to 74 | 900 |
| Number Of Beneficiaries Age 75 to 84 | 582 |
| Number Of Beneficiaries Age Greater 84 | 128 |
| Number Of Female Beneficiaries | 1056 |
| Number Of Male Beneficiaries | 723 |
| Number Of Non Hispanic White Beneficiaries | 1578 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0069 |