| National Provider Identifier [NPI]: | 1407856610 |
| Last Name Of The Provider | BACON |
| First Name Of The Provider | GEOFFREY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 ENTERPRISE PARKWAY |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | HAMPTON |
| Zip Code Of The Provider | 236662583 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 40108 |
| Number Of Medicare Beneficiaries | 1521 |
| Total Submitted Charge Amount | 1761078.78 |
| Total Medicare Allowed Amount | 1205320.03 |
| Total Medicare Payment Amount | 904888.44 |
| Total Medicare Standardized Payment Amount | 898132.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 4435 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 137609.5 |
| Total Drug Medicare AllowedAmount | 117390.86 |
| Total Drug Medicare PaymentAmount | 92033.64 |
| Total Drug Medicare Standardized Payment Amount | 92033.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 35673 |
| Number Of Medicare Beneficiaries With Medical Services | 1521 |
| Total Medical Submitted Charge Amount | 1623469.28 |
| Total Medical Medicare Allowed Amount | 1087929.17 |
| Total Medical Medicare Payment Amount | 812854.8 |
| Total Medical Medicare Standardized Payment Amount | 806098.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 170 |
| Number Of Beneficiaries Age 65 to 74 | 677 |
| Number Of Beneficiaries Age 75 to 84 | 484 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 964 |
| Number Of Male Beneficiaries | 557 |
| Number Of Non Hispanic White Beneficiaries | 929 |
| Number Of Black or African American Beneficiaries | 537 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.203 |