| National Provider Identifier [NPI]: | 1598887275 |
| Last Name Of The Provider | BOCCARDO |
| First Name Of The Provider | JUSTIN |
| 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 | 1086 FRANKLIN ST |
| Street Address 2 Of The Provider | 3RD FLOOR, BLDG. M, ROOM 3002 |
| City Of The Provider | JOHNSTOWN |
| Zip Code Of The Provider | 159054305 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 1461 |
| Number Of Medicare Beneficiaries | 856 |
| Total Submitted Charge Amount | 922513 |
| Total Medicare Allowed Amount | 129806.25 |
| Total Medicare Payment Amount | 100388.64 |
| Total Medicare Standardized Payment Amount | 101042.32 |
| 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 | 100 |
| Number Of Medical Services | 1461 |
| Number Of Medicare Beneficiaries With Medical Services | 856 |
| Total Medical Submitted Charge Amount | 922513 |
| Total Medical Medicare Allowed Amount | 129806.25 |
| Total Medical Medicare Payment Amount | 100388.64 |
| Total Medical Medicare Standardized Payment Amount | 101042.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 283 |
| Number Of Beneficiaries Age 75 to 84 | 227 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 441 |
| Number Of Male Beneficiaries | 415 |
| Number Of Non Hispanic White Beneficiaries | 804 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 538 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 318 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1174 |