| National Provider Identifier [NPI]: | 1215905260 |
| Last Name Of The Provider | PRIMACK |
| First Name Of The Provider | DAREN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1801 E MARCH LN |
| Street Address 2 Of The Provider | STE. D400 |
| City Of The Provider | STOCKTON |
| Zip Code Of The Provider | 952106629 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 5544 |
| Number Of Medicare Beneficiaries | 1098 |
| Total Submitted Charge Amount | 2429684.5 |
| Total Medicare Allowed Amount | 727829.27 |
| Total Medicare Payment Amount | 552231.53 |
| Total Medicare Standardized Payment Amount | 528598.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 763 |
| Number Of Medicare Beneficiaries With Drug Services | 211 |
| Total Drug Submitted ChargeAmount | 188330 |
| Total Drug Medicare AllowedAmount | 26375.42 |
| Total Drug Medicare PaymentAmount | 20553.33 |
| Total Drug Medicare Standardized Payment Amount | 20553.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 4781 |
| Number Of Medicare Beneficiaries With Medical Services | 1098 |
| Total Medical Submitted Charge Amount | 2241354.5 |
| Total Medical Medicare Allowed Amount | 701453.85 |
| Total Medical Medicare Payment Amount | 531678.2 |
| Total Medical Medicare Standardized Payment Amount | 508045.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 436 |
| Number Of Beneficiaries Age 75 to 84 | 358 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 583 |
| Number Of Male Beneficiaries | 515 |
| Number Of Non Hispanic White Beneficiaries | 756 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 68 |
| Number Of Hispanic Beneficiaries | 202 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 731 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 367 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5627 |