| National Provider Identifier [NPI]: | 1164403580 |
| Last Name Of The Provider | BLOOM |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 YORK STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOUGHTON |
| Zip Code Of The Provider | 020724827 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1327 |
| Number Of Medicare Beneficiaries | 479 |
| Total Submitted Charge Amount | 362711 |
| Total Medicare Allowed Amount | 104097.11 |
| Total Medicare Payment Amount | 80211.56 |
| Total Medicare Standardized Payment Amount | 77686.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 3439 |
| Total Drug Medicare AllowedAmount | 1661.22 |
| Total Drug Medicare PaymentAmount | 1627.96 |
| Total Drug Medicare Standardized Payment Amount | 1627.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1306 |
| Number Of Medicare Beneficiaries With Medical Services | 479 |
| Total Medical Submitted Charge Amount | 359272 |
| Total Medical Medicare Allowed Amount | 102435.89 |
| Total Medical Medicare Payment Amount | 78583.6 |
| Total Medical Medicare Standardized Payment Amount | 76058.73 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 178 |
| Number Of Beneficiaries Age 75 to 84 | 134 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 214 |
| Number Of Non Hispanic White Beneficiaries | 426 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 318 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 57 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.0331 |