| National Provider Identifier [NPI]: | 1609804293 |
| Last Name Of The Provider | PAK |
| First Name Of The Provider | WANDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3301 NEW MEXICO AVE NW |
| Street Address 2 Of The Provider | SUITE 226 |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 200163622 |
| State Code Of The Provider | DC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1565 |
| Number Of Medicare Beneficiaries | 397 |
| Total Submitted Charge Amount | 359553 |
| Total Medicare Allowed Amount | 151298.5 |
| Total Medicare Payment Amount | 107540.21 |
| Total Medicare Standardized Payment Amount | 94203.68 |
| 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 | 21 |
| Number Of Medical Services | 1565 |
| Number Of Medicare Beneficiaries With Medical Services | 397 |
| Total Medical Submitted Charge Amount | 359553 |
| Total Medical Medicare Allowed Amount | 151298.5 |
| Total Medical Medicare Payment Amount | 107540.21 |
| Total Medical Medicare Standardized Payment Amount | 94203.68 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 160 |
| Number Of Non Hispanic White Beneficiaries | 275 |
| Number Of Black or African American Beneficiaries | 92 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 342 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9672 |