| National Provider Identifier [NPI]: | 1265461701 |
| Last Name Of The Provider | BORGHESANI |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D.-PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | UNIVERSTY OF WASHINGTON MEDICAL CENTER |
| Street Address 2 Of The Provider | DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCE |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981950001 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 589 |
| Number Of Medicare Beneficiaries | 96 |
| Total Submitted Charge Amount | 107322.1 |
| Total Medicare Allowed Amount | 51373.17 |
| Total Medicare Payment Amount | 40207.26 |
| Total Medicare Standardized Payment Amount | 38545.84 |
| 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 | 9 |
| Number Of Medical Services | 589 |
| Number Of Medicare Beneficiaries With Medical Services | 96 |
| Total Medical Submitted Charge Amount | 107322.1 |
| Total Medical Medicare Allowed Amount | 51373.17 |
| Total Medical Medicare Payment Amount | 40207.26 |
| Total Medical Medicare Standardized Payment Amount | 38545.84 |
| Average Age Of Beneficiaries | 49 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | 56 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 13 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 75 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.5047 |