| National Provider Identifier [NPI]: | 1013991942 |
| Last Name Of The Provider | RICH |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 332 HANOVER STREET NHC |
| Street Address 2 Of The Provider | NORTH END COMMUNITY HEALTH CENTER |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021131901 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 404 |
| Number Of Medicare Beneficiaries | 106 |
| Total Submitted Charge Amount | 16102 |
| Total Medicare Allowed Amount | 4303.6 |
| Total Medicare Payment Amount | 3607.48 |
| Total Medicare Standardized Payment Amount | 3512.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 55 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2857 |
| Total Drug Medicare AllowedAmount | 1899.57 |
| Total Drug Medicare PaymentAmount | 1860.17 |
| Total Drug Medicare Standardized Payment Amount | 1860.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 349 |
| Number Of Medicare Beneficiaries With Medical Services | 103 |
| Total Medical Submitted Charge Amount | 13245 |
| Total Medical Medicare Allowed Amount | 2404.03 |
| Total Medical Medicare Payment Amount | 1747.31 |
| Total Medical Medicare Standardized Payment Amount | 1652.12 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 20 |
| 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 | 79 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.2102 |