| National Provider Identifier [NPI]: | 1336241330 |
| Last Name Of The Provider | PATT-BOGUT |
| First Name Of The Provider | MAUREEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2325 MARYLAND RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | WILLOW GROVE |
| Zip Code Of The Provider | 190901749 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 647 |
| Number Of Medicare Beneficiaries | 379 |
| Total Submitted Charge Amount | 110371 |
| Total Medicare Allowed Amount | 52754.42 |
| Total Medicare Payment Amount | 41197.27 |
| Total Medicare Standardized Payment Amount | 46159.42 |
| 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 | 12 |
| Number Of Medical Services | 647 |
| Number Of Medicare Beneficiaries With Medical Services | 379 |
| Total Medical Submitted Charge Amount | 110371 |
| Total Medical Medicare Allowed Amount | 52754.42 |
| Total Medical Medicare Payment Amount | 41197.27 |
| Total Medical Medicare Standardized Payment Amount | 46159.42 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | 309 |
| Number Of Black or African American Beneficiaries | 57 |
| 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 | 304 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 69 |
| Average HCC Risk Score Of Beneficiaries | 1.986 |