| National Provider Identifier [NPI]: | 1407930209 |
| Last Name Of The Provider | PARDOE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2752 HARRISON AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | EUREKA |
| Zip Code Of The Provider | 955014738 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 1941 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 347877.08 |
| Total Medicare Allowed Amount | 172984.02 |
| Total Medicare Payment Amount | 126895.41 |
| Total Medicare Standardized Payment Amount | 121651.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 337 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 20849 |
| Total Drug Medicare AllowedAmount | 10509.51 |
| Total Drug Medicare PaymentAmount | 8231.97 |
| Total Drug Medicare Standardized Payment Amount | 8231.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 1604 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 327028.08 |
| Total Medical Medicare Allowed Amount | 162474.51 |
| Total Medical Medicare Payment Amount | 118663.44 |
| Total Medical Medicare Standardized Payment Amount | 113419.65 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 333 |
| 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 | 305 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0241 |