National Provider Identifier [NPI]: |
1235102534 |
Last Name Of The Provider |
ARELLANO |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 FRUIT ST |
Street Address 2 Of The Provider |
WHITE 270 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142621 |
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 |
133 |
Number Of Services |
3204 |
Number Of Medicare Beneficiaries |
638 |
Total Submitted Charge Amount |
535628 |
Total Medicare Allowed Amount |
128840.12 |
Total Medicare Payment Amount |
98234.74 |
Total Medicare Standardized Payment Amount |
92543.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
2012 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
3192 |
Total Drug Medicare AllowedAmount |
760.56 |
Total Drug Medicare PaymentAmount |
596.27 |
Total Drug Medicare Standardized Payment Amount |
596.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
130 |
Number Of Medical Services |
1192 |
Number Of Medicare Beneficiaries With Medical Services |
638 |
Total Medical Submitted Charge Amount |
532436 |
Total Medical Medicare Allowed Amount |
128079.56 |
Total Medical Medicare Payment Amount |
97638.47 |
Total Medical Medicare Standardized Payment Amount |
91947.58 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
258 |
Number Of Beneficiaries Age 75 to 84 |
188 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
329 |
Number Of Non Hispanic White Beneficiaries |
558 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
171 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.3528 |