| National Provider Identifier [NPI]: | 1487645669 |
| Last Name Of The Provider | STEWART |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST FND 216 |
| Street Address 2 Of The Provider | MASSACHUSETTS GENERAL HOSPITAL |
| 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 | 170 |
| Number Of Services | 6454 |
| Number Of Medicare Beneficiaries | 3142 |
| Total Submitted Charge Amount | 662581.23 |
| Total Medicare Allowed Amount | 188695.21 |
| Total Medicare Payment Amount | 141864.52 |
| Total Medicare Standardized Payment Amount | 140296.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2018 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 6570 |
| Total Drug Medicare AllowedAmount | 441.84 |
| Total Drug Medicare PaymentAmount | 346.41 |
| Total Drug Medicare Standardized Payment Amount | 346.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 4436 |
| Number Of Medicare Beneficiaries With Medical Services | 3142 |
| Total Medical Submitted Charge Amount | 656011.23 |
| Total Medical Medicare Allowed Amount | 188253.37 |
| Total Medical Medicare Payment Amount | 141518.11 |
| Total Medical Medicare Standardized Payment Amount | 139950.57 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 583 |
| Number Of Beneficiaries Age 65 to 74 | 1096 |
| Number Of Beneficiaries Age 75 to 84 | 887 |
| Number Of Beneficiaries Age Greater 84 | 576 |
| Number Of Female Beneficiaries | 1865 |
| Number Of Male Beneficiaries | 1277 |
| Number Of Non Hispanic White Beneficiaries | 2814 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 174 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 961 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7358 |