| National Provider Identifier [NPI]: | 1780754291 |
| Last Name Of The Provider | MEEHAN |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 SPRING ST FL 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100123645 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 303 |
| Number Of Medicare Beneficiaries | 45 |
| Total Submitted Charge Amount | 45043 |
| Total Medicare Allowed Amount | 22610.34 |
| Total Medicare Payment Amount | 17326.52 |
| Total Medicare Standardized Payment Amount | 15464.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 980 |
| Total Drug Medicare AllowedAmount | 555 |
| Total Drug Medicare PaymentAmount | 543.49 |
| Total Drug Medicare Standardized Payment Amount | 543.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 286 |
| Number Of Medicare Beneficiaries With Medical Services | 45 |
| Total Medical Submitted Charge Amount | 44063 |
| Total Medical Medicare Allowed Amount | 22055.34 |
| Total Medical Medicare Payment Amount | 16783.03 |
| Total Medical Medicare Standardized Payment Amount | 14921 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 21 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 0 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9336 |