| National Provider Identifier [NPI]: | 1154445203 |
| Last Name Of The Provider | ABBOTT |
| First Name Of The Provider | ZACHARY |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 CAPITAL MALL DR SW |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985028654 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 6411 |
| Number Of Medicare Beneficiaries | 1231 |
| Total Submitted Charge Amount | 1715482.72 |
| Total Medicare Allowed Amount | 488496 |
| Total Medicare Payment Amount | 364615.46 |
| Total Medicare Standardized Payment Amount | 353147.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2996 |
| Number Of Medicare Beneficiaries With Drug Services | 829 |
| Total Drug Submitted ChargeAmount | 27092.81 |
| Total Drug Medicare AllowedAmount | 2003.97 |
| Total Drug Medicare PaymentAmount | 1528.77 |
| Total Drug Medicare Standardized Payment Amount | 1528.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 3415 |
| Number Of Medicare Beneficiaries With Medical Services | 1228 |
| Total Medical Submitted Charge Amount | 1688389.91 |
| Total Medical Medicare Allowed Amount | 486492.03 |
| Total Medical Medicare Payment Amount | 363086.69 |
| Total Medical Medicare Standardized Payment Amount | 351618.98 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 575 |
| Number Of Beneficiaries Age 75 to 84 | 358 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 713 |
| Number Of Male Beneficiaries | 518 |
| Number Of Non Hispanic White Beneficiaries | 1152 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1083 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9779 |