| National Provider Identifier [NPI]: | 1639131352 |
| Last Name Of The Provider | TRISTER |
| First Name Of The Provider | JON |
| 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 | 10 WINTHROP ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016044435 |
| 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 | 85 |
| Number Of Services | 5248 |
| Number Of Medicare Beneficiaries | 450 |
| Total Submitted Charge Amount | 735763.6 |
| Total Medicare Allowed Amount | 304722.7 |
| Total Medicare Payment Amount | 219607.48 |
| Total Medicare Standardized Payment Amount | 209576.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1229 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 36527.6 |
| Total Drug Medicare AllowedAmount | 3780.38 |
| Total Drug Medicare PaymentAmount | 3258.97 |
| Total Drug Medicare Standardized Payment Amount | 3258.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 4019 |
| Number Of Medicare Beneficiaries With Medical Services | 450 |
| Total Medical Submitted Charge Amount | 699236 |
| Total Medical Medicare Allowed Amount | 300942.32 |
| Total Medical Medicare Payment Amount | 216348.51 |
| Total Medical Medicare Standardized Payment Amount | 206317.54 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 152 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 381 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 252 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2859 |