National Provider Identifier [NPI]: |
1215104310 |
Last Name Of The Provider |
HITO |
First Name Of The Provider |
RANIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
88 E NEWTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021182308 |
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 |
58 |
Number Of Services |
1772 |
Number Of Medicare Beneficiaries |
869 |
Total Submitted Charge Amount |
483194 |
Total Medicare Allowed Amount |
92921.77 |
Total Medicare Payment Amount |
71131.36 |
Total Medicare Standardized Payment Amount |
70116.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
615 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
3535 |
Total Drug Medicare AllowedAmount |
757.82 |
Total Drug Medicare PaymentAmount |
594.16 |
Total Drug Medicare Standardized Payment Amount |
594.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1157 |
Number Of Medicare Beneficiaries With Medical Services |
869 |
Total Medical Submitted Charge Amount |
479659 |
Total Medical Medicare Allowed Amount |
92163.95 |
Total Medical Medicare Payment Amount |
70537.2 |
Total Medical Medicare Standardized Payment Amount |
69522.43 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
208 |
Number Of Beneficiaries Age 65 to 74 |
302 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
458 |
Number Of Male Beneficiaries |
411 |
Number Of Non Hispanic White Beneficiaries |
776 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
580 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
289 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
1.8499 |