| National Provider Identifier [NPI]: | 1629064266 |
| Last Name Of The Provider | SACRY |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 108 FIRST ST W |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHITEHALL |
| Zip Code Of The Provider | 597590339 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 2027 |
| Number Of Medicare Beneficiaries | 291 |
| Total Submitted Charge Amount | 117185 |
| Total Medicare Allowed Amount | 62005.25 |
| Total Medicare Payment Amount | 41677.01 |
| Total Medicare Standardized Payment Amount | 50142.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 481 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 4833 |
| Total Drug Medicare AllowedAmount | 3275.77 |
| Total Drug Medicare PaymentAmount | 2876.4 |
| Total Drug Medicare Standardized Payment Amount | 2876.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1546 |
| Number Of Medicare Beneficiaries With Medical Services | 291 |
| Total Medical Submitted Charge Amount | 112352 |
| Total Medical Medicare Allowed Amount | 58729.48 |
| Total Medical Medicare Payment Amount | 38800.61 |
| Total Medical Medicare Standardized Payment Amount | 47266.07 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 147 |
| Number Of Male Beneficiaries | 144 |
| 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 | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0142 |