| National Provider Identifier [NPI]: | 1063430395 |
| Last Name Of The Provider | DAVIDOFF |
| First Name Of The Provider | ASHLEY |
| 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 | 736 CAMBRIDGE ST |
| Street Address 2 Of The Provider | RADIOLOGY CMP 4 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021352907 |
| 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 | 153 |
| Number Of Services | 2232 |
| Number Of Medicare Beneficiaries | 1242 |
| Total Submitted Charge Amount | 249680 |
| Total Medicare Allowed Amount | 71788.4 |
| Total Medicare Payment Amount | 54768.91 |
| Total Medicare Standardized Payment Amount | 53197.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 2232 |
| Number Of Medicare Beneficiaries With Medical Services | 1242 |
| Total Medical Submitted Charge Amount | 249680 |
| Total Medical Medicare Allowed Amount | 71788.4 |
| Total Medical Medicare Payment Amount | 54768.91 |
| Total Medical Medicare Standardized Payment Amount | 53197.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 351 |
| Number Of Beneficiaries Age 75 to 84 | 388 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 654 |
| Number Of Male Beneficiaries | 588 |
| Number Of Non Hispanic White Beneficiaries | 1050 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 559 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1701 |