| National Provider Identifier [NPI]: | 1336248038 |
| Last Name Of The Provider | ELENTUCK |
| First Name Of The Provider | DMITRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LAHEY CLINIC |
| Street Address 2 Of The Provider | 41 MALL ROAD |
| City Of The Provider | BURLINGTON |
| Zip Code Of The Provider | 018050001 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 4124 |
| Number Of Medicare Beneficiaries | 2970 |
| Total Submitted Charge Amount | 492134 |
| Total Medicare Allowed Amount | 132696.23 |
| Total Medicare Payment Amount | 99367.98 |
| Total Medicare Standardized Payment Amount | 96106.68 |
| 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 | 127 |
| Number Of Medical Services | 4124 |
| Number Of Medicare Beneficiaries With Medical Services | 2970 |
| Total Medical Submitted Charge Amount | 492134 |
| Total Medical Medicare Allowed Amount | 132696.23 |
| Total Medical Medicare Payment Amount | 99367.98 |
| Total Medical Medicare Standardized Payment Amount | 96106.68 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 389 |
| Number Of Beneficiaries Age 65 to 74 | 1160 |
| Number Of Beneficiaries Age 75 to 84 | 954 |
| Number Of Beneficiaries Age Greater 84 | 467 |
| Number Of Female Beneficiaries | 1885 |
| Number Of Male Beneficiaries | 1085 |
| Number Of Non Hispanic White Beneficiaries | 2755 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2485 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 485 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4377 |