| National Provider Identifier [NPI]: | 1366414088 |
| Last Name Of The Provider | DISTAZIO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 495 WATERFRONT DR E |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | HOMESTEAD |
| Zip Code Of The Provider | 151201140 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1730 |
| Number Of Medicare Beneficiaries | 370 |
| Total Submitted Charge Amount | 142576.5 |
| Total Medicare Allowed Amount | 97554.36 |
| Total Medicare Payment Amount | 70912.75 |
| Total Medicare Standardized Payment Amount | 73784.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 276.5 |
| Total Drug Medicare AllowedAmount | 120.94 |
| Total Drug Medicare PaymentAmount | 91.98 |
| Total Drug Medicare Standardized Payment Amount | 91.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1662 |
| Number Of Medicare Beneficiaries With Medical Services | 370 |
| Total Medical Submitted Charge Amount | 142300 |
| Total Medical Medicare Allowed Amount | 97433.42 |
| Total Medical Medicare Payment Amount | 70820.77 |
| Total Medical Medicare Standardized Payment Amount | 73692.62 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 240 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| 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 | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4122 |