| National Provider Identifier [NPI]: | 1992700330 |
| Last Name Of The Provider | PAULOS |
| First Name Of The Provider | LEON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 324 10TH AVE |
| Street Address 2 Of The Provider | SUITE 175 |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841032853 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 799 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 246456.65 |
| Total Medicare Allowed Amount | 91758.62 |
| Total Medicare Payment Amount | 68306.58 |
| Total Medicare Standardized Payment Amount | 72464.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 260 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 12381 |
| Total Drug Medicare AllowedAmount | 7795.11 |
| Total Drug Medicare PaymentAmount | 5858.43 |
| Total Drug Medicare Standardized Payment Amount | 5858.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 539 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 234075.65 |
| Total Medical Medicare Allowed Amount | 83963.51 |
| Total Medical Medicare Payment Amount | 62448.15 |
| Total Medical Medicare Standardized Payment Amount | 66606.5 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 39 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.8559 |