| National Provider Identifier [NPI]: | 1689623886 |
| Last Name Of The Provider | DIGUMARTHY |
| First Name Of The Provider | SUBBA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT STREET FND 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021143117 |
| 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 | 22 |
| Number Of Services | 39879 |
| Number Of Medicare Beneficiaries | 2308 |
| Total Submitted Charge Amount | 1100921 |
| Total Medicare Allowed Amount | 207173.76 |
| Total Medicare Payment Amount | 155307.42 |
| Total Medicare Standardized Payment Amount | 154863.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 36793 |
| Number Of Medicare Beneficiaries With Drug Services | 387 |
| Total Drug Submitted ChargeAmount | 37273 |
| Total Drug Medicare AllowedAmount | 6875.16 |
| Total Drug Medicare PaymentAmount | 5355.33 |
| Total Drug Medicare Standardized Payment Amount | 5355.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 3086 |
| Number Of Medicare Beneficiaries With Medical Services | 2308 |
| Total Medical Submitted Charge Amount | 1063648 |
| Total Medical Medicare Allowed Amount | 200298.6 |
| Total Medical Medicare Payment Amount | 149952.09 |
| Total Medical Medicare Standardized Payment Amount | 149508.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 340 |
| Number Of Beneficiaries Age 65 to 74 | 973 |
| Number Of Beneficiaries Age 75 to 84 | 748 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 1133 |
| Number Of Male Beneficiaries | 1175 |
| Number Of Non Hispanic White Beneficiaries | 2069 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 524 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 35 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3545 |