| National Provider Identifier [NPI]: | 1750362372 |
| Last Name Of The Provider | MCLOUD |
| First Name Of The Provider | THERESA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | FND 2 RADIOLOGICAL ASSOCIATES |
| 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 | 11 |
| Number Of Services | 10538 |
| Number Of Medicare Beneficiaries | 2220 |
| Total Submitted Charge Amount | 376790 |
| Total Medicare Allowed Amount | 83917.98 |
| Total Medicare Payment Amount | 63545.86 |
| Total Medicare Standardized Payment Amount | 62059.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 7420 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 7420 |
| Total Drug Medicare AllowedAmount | 1388.58 |
| Total Drug Medicare PaymentAmount | 1079.11 |
| Total Drug Medicare Standardized Payment Amount | 1079.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 3118 |
| Number Of Medicare Beneficiaries With Medical Services | 2219 |
| Total Medical Submitted Charge Amount | 369370 |
| Total Medical Medicare Allowed Amount | 82529.4 |
| Total Medical Medicare Payment Amount | 62466.75 |
| Total Medical Medicare Standardized Payment Amount | 60980.07 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 365 |
| Number Of Beneficiaries Age 65 to 74 | 835 |
| Number Of Beneficiaries Age 75 to 84 | 709 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 1016 |
| Number Of Male Beneficiaries | 1204 |
| Number Of Non Hispanic White Beneficiaries | 1989 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1676 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 544 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3255 |