| National Provider Identifier [NPI]: | 1821105164 |
| Last Name Of The Provider | DIACONOU |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD PS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 N DIVISION ST |
| Street Address 2 Of The Provider | STE 402 |
| City Of The Provider | AUBURN |
| Zip Code Of The Provider | 980014939 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 2634 |
| Number Of Medicare Beneficiaries | 1487 |
| Total Submitted Charge Amount | 1214263 |
| Total Medicare Allowed Amount | 376537.03 |
| Total Medicare Payment Amount | 283477.09 |
| Total Medicare Standardized Payment Amount | 269285.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 2634 |
| Number Of Medicare Beneficiaries With Medical Services | 1487 |
| Total Medical Submitted Charge Amount | 1214263 |
| Total Medical Medicare Allowed Amount | 376537.03 |
| Total Medical Medicare Payment Amount | 283477.09 |
| Total Medical Medicare Standardized Payment Amount | 269285.51 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 512 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 274 |
| Number Of Female Beneficiaries | 804 |
| Number Of Male Beneficiaries | 683 |
| Number Of Non Hispanic White Beneficiaries | 1304 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1215 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 272 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6772 |