| National Provider Identifier [NPI]: | 1528285467 |
| Last Name Of The Provider | YAKIREVICH |
| First Name Of The Provider | EVGENY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 593 EDDY ST |
| Street Address 2 Of The Provider | DEPARTMENT OF PATHOLOGY RIH APC 12 |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029034923 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1456 |
| Number Of Medicare Beneficiaries | 489 |
| Total Submitted Charge Amount | 427174.96 |
| Total Medicare Allowed Amount | 51905.65 |
| Total Medicare Payment Amount | 39505.96 |
| Total Medicare Standardized Payment Amount | 27337.3 |
| 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 | 18 |
| Number Of Medical Services | 1456 |
| Number Of Medicare Beneficiaries With Medical Services | 489 |
| Total Medical Submitted Charge Amount | 427174.96 |
| Total Medical Medicare Allowed Amount | 51905.65 |
| Total Medical Medicare Payment Amount | 39505.96 |
| Total Medical Medicare Standardized Payment Amount | 27337.3 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 284 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 374 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 319 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4499 |