| National Provider Identifier [NPI]: | 1508084716 |
| Last Name Of The Provider | HEALEY |
| First Name Of The Provider | TERRANCE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 593 EDDY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029034923 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 8263 |
| Number Of Medicare Beneficiaries | 3173 |
| Total Submitted Charge Amount | 474757.5 |
| Total Medicare Allowed Amount | 151015.84 |
| Total Medicare Payment Amount | 110922.13 |
| Total Medicare Standardized Payment Amount | 107358.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2475 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1777.5 |
| Total Drug Medicare AllowedAmount | 612.75 |
| Total Drug Medicare PaymentAmount | 480.35 |
| Total Drug Medicare Standardized Payment Amount | 480.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 5788 |
| Number Of Medicare Beneficiaries With Medical Services | 3173 |
| Total Medical Submitted Charge Amount | 472980 |
| Total Medical Medicare Allowed Amount | 150403.09 |
| Total Medical Medicare Payment Amount | 110441.78 |
| Total Medical Medicare Standardized Payment Amount | 106877.85 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 749 |
| Number Of Beneficiaries Age 65 to 74 | 1038 |
| Number Of Beneficiaries Age 75 to 84 | 820 |
| Number Of Beneficiaries Age Greater 84 | 566 |
| Number Of Female Beneficiaries | 1737 |
| Number Of Male Beneficiaries | 1436 |
| Number Of Non Hispanic White Beneficiaries | 2525 |
| Number Of Black or African American Beneficiaries | 187 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 347 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1975 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1198 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0203 |