| National Provider Identifier [NPI]: | 1912981713 |
| Last Name Of The Provider | TARASENKO |
| First Name Of The Provider | VALERY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 BUTCHER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | VACAVILLE |
| Zip Code Of The Provider | 956875616 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 11334 |
| Number Of Medicare Beneficiaries | 300 |
| Total Submitted Charge Amount | 1366848 |
| Total Medicare Allowed Amount | 674915.87 |
| Total Medicare Payment Amount | 515014.5 |
| Total Medicare Standardized Payment Amount | 377509.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7829 |
| Number Of Medicare Beneficiaries With Drug Services | 209 |
| Total Drug Submitted ChargeAmount | 197561 |
| Total Drug Medicare AllowedAmount | 66797.54 |
| Total Drug Medicare PaymentAmount | 51871.44 |
| Total Drug Medicare Standardized Payment Amount | 51871.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3505 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 1169287 |
| Total Medical Medicare Allowed Amount | 608118.33 |
| Total Medical Medicare Payment Amount | 463143.06 |
| Total Medical Medicare Standardized Payment Amount | 325638.06 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 207 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 213 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0684 |