| National Provider Identifier [NPI]: | 1831197748 |
| Last Name Of The Provider | PAUL-BLANC |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16 CREEDEN ST |
| Street Address 2 Of The Provider | #4 |
| City Of The Provider | MANSFIELD |
| Zip Code Of The Provider | 020481212 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 1839 |
| Number Of Medicare Beneficiaries | 644 |
| Total Submitted Charge Amount | 637831.82 |
| Total Medicare Allowed Amount | 202837.44 |
| Total Medicare Payment Amount | 147330.26 |
| Total Medicare Standardized Payment Amount | 147403.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 47121.36 |
| Total Drug Medicare AllowedAmount | 17576.89 |
| Total Drug Medicare PaymentAmount | 13749.08 |
| Total Drug Medicare Standardized Payment Amount | 13749.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 1761 |
| Number Of Medicare Beneficiaries With Medical Services | 644 |
| Total Medical Submitted Charge Amount | 590710.46 |
| Total Medical Medicare Allowed Amount | 185260.55 |
| Total Medical Medicare Payment Amount | 133581.18 |
| Total Medical Medicare Standardized Payment Amount | 133654.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 502 |
| Number Of Non Hispanic White Beneficiaries | 615 |
| 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 | 531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3252 |