| National Provider Identifier [NPI]: | 1376651885 |
| Last Name Of The Provider | PELLATT |
| First Name Of The Provider | MORTON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9500 S 1300 E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANDY |
| Zip Code Of The Provider | 840943763 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2626 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 178815 |
| Total Medicare Allowed Amount | 123188.83 |
| Total Medicare Payment Amount | 93049.83 |
| Total Medicare Standardized Payment Amount | 97530.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 260 |
| Number Of Medicare Beneficiaries With Drug Services | 155 |
| Total Drug Submitted ChargeAmount | 13160 |
| Total Drug Medicare AllowedAmount | 11700.2 |
| Total Drug Medicare PaymentAmount | 11376.39 |
| Total Drug Medicare Standardized Payment Amount | 11376.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 2366 |
| Number Of Medicare Beneficiaries With Medical Services | 387 |
| Total Medical Submitted Charge Amount | 165655 |
| Total Medical Medicare Allowed Amount | 111488.63 |
| Total Medical Medicare Payment Amount | 81673.44 |
| Total Medical Medicare Standardized Payment Amount | 86154.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 368 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9183 |