| National Provider Identifier [NPI]: | 1396769634 |
| Last Name Of The Provider | BACON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 153RD ST SE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MILL CREEK |
| Zip Code Of The Provider | 980124051 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 448 |
| Number Of Medicare Beneficiaries | 85 |
| Total Submitted Charge Amount | 67309 |
| Total Medicare Allowed Amount | 31317.08 |
| Total Medicare Payment Amount | 22038.31 |
| Total Medicare Standardized Payment Amount | 23270.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 922 |
| Total Drug Medicare AllowedAmount | 666.23 |
| Total Drug Medicare PaymentAmount | 620.24 |
| Total Drug Medicare Standardized Payment Amount | 620.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 391 |
| Number Of Medicare Beneficiaries With Medical Services | 85 |
| Total Medical Submitted Charge Amount | 66387 |
| Total Medical Medicare Allowed Amount | 30650.85 |
| Total Medical Medicare Payment Amount | 21418.07 |
| Total Medical Medicare Standardized Payment Amount | 22650.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 38 |
| 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 | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 36 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7961 |