| National Provider Identifier [NPI]: | 1669468997 |
| Last Name Of The Provider | PRISUTA |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4469 RED ROCK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BENTON |
| Zip Code Of The Provider | 178147606 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2470 |
| Number Of Medicare Beneficiaries | 454 |
| Total Submitted Charge Amount | 260377 |
| Total Medicare Allowed Amount | 145930.84 |
| Total Medicare Payment Amount | 102264.39 |
| Total Medicare Standardized Payment Amount | 106317.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 248 |
| Number Of Medicare Beneficiaries With Drug Services | 167 |
| Total Drug Submitted ChargeAmount | 9044 |
| Total Drug Medicare AllowedAmount | 6104.51 |
| Total Drug Medicare PaymentAmount | 5933.86 |
| Total Drug Medicare Standardized Payment Amount | 5933.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2222 |
| Number Of Medicare Beneficiaries With Medical Services | 453 |
| Total Medical Submitted Charge Amount | 251333 |
| Total Medical Medicare Allowed Amount | 139826.33 |
| Total Medical Medicare Payment Amount | 96330.53 |
| Total Medical Medicare Standardized Payment Amount | 100383.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 244 |
| Number Of Male Beneficiaries | 210 |
| 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 | 338 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1274 |